Terapia biológica mediante el uso de linfocitos T con receptores de antígenos quiméricos (CAR-T CELLS) para la leucemia linfoide aguda refractaria: Revisión sistemática

Abstract

Introduction: Acute Lymphoid Leukemia Refractory is a type of hematological cancer with an overproduction of B or T lymphocytes despite first-line treatment. Patients often do not survive relapse; modern treatments have been investigated for new targets, including Biological Therapy using chimeric antigen receptor T-lymphocytes. Objective: To analyze the efficacy and describe the adverse effects of using chimeric antigen receptor T-cell biologic therapy for treating refractory acute lymphoid leukemia. Methodology: A systematic review was performed in English, in databases such as Scopus, PubMed, Web of Science, and Cochrane, of clinical trials published in the last five years involving patients with refractory acute lymphoid leukemia. The search strategy used MeSH terms through the equation "Biological therapy" AND "T-Lymphocytes" AND "Receptors Chimeric antigen" AND "Refractory" NOT "Multiple myeloma" NOT "Lymphoma" and the quality of the information was evaluated with the New-Castle Ottawa Scale tool. Results: Six clinical trials were included, totaling 127 patients studied. Of the six studies performed, three were negative for minimal residual disease, while in the remaining studies, patients were found to be in complete remission with incomplete hematologic recovery. The most common adverse effect was cytokine release syndrome in 55-100%, followed by immune effector cell-associated neurotoxicity syndrome in 4.3-40%. Conclusions: The complete remission of this disease averaged more than 80% biological therapy with CAR-T cells. However, the side effects caused by CAR-T cells can be life-threatening. Research of CAR-T cells for patients with refractory T-cell acute lymphoid leukemia is needed, as the databases have not provided information on this subject.