BiTEs and CAR-Ts : immunotherapy in childhood B-cell acute lymphoblastic leukemia

Abstract

B-cell acute lymphoblastic leukemia is the most common pediatric cancer, responsible for the most cancer-related deaths in children. Advances in chemotherapy over the past half-century have steadily increased the remission and survival of children with B-cell acute lymphoblastic leukemia to nearly 90%. However, the problems of minimal residual disease and relapsed and refractory disease persist. Personalized, targeted therapies have improved outcomes among the minority of patients for whom chemotherapy is ineffective. Immunotherapy, specifically bispecific T-cell engaging antibody therapy and chimeric antigen receptor T-cell therapy, has proven an effective treatment for relapsed and refractory B-cell acute lymphoblastic leukemia in children. These new modalities, however, have also introduced new adverse side effects to the treatment regimen. Though immunotherapy has increased remission and survival, more work must be done to reduce adverse effects and eliminate relapsed and refractory disease.