T-cell
acute lymphoblastic leukemia (
T-ALL), a form of T-cell
malignancy, is a typically aggressive
hematological malignancy with high rates of disease relapse and a poor prognosis. Current guidelines do not recommend any specific treatments for these patients, and only allogeneic stem cell transplant, which is associated with potential risks and toxicities, is a curative
therapy. Recent clinical trials showed that
immunotherapies, including
monoclonal antibodies, checkpoint inhibitors, and CAR T
therapies, are successful in treating
hematologic malignancies. CAR T cells, which specifically target the B-
cell surface antigen CD19, have demonstrated remarkable efficacy in the treatment of B-cell acute
leukemia, and some progress has been made in the treatment of other
hematologic malignancies. However, the development of CAR T-cell
immunotherapy targeting T-cell
malignancies appears more challenging due to the potential risks of fratricide, T-cell aplasia, immunosuppression, and product contamination. In this review, we discuss the current status of and challenges related to CAR T-cell
immunotherapy for
T-ALL and review potential strategies to overcome these limitations.