Abstract

Chimeric antigen receptor T-cell therapy (CAR T-cell therapy) has emerged as a groundbreaking treatment for relapsed or refractory B-cell lymphomas and leukemia. This personalized immunotherapy has demonstrated high efficacy, with complete remission (CR) rates ranging from 40% to over 80% in aggressive forms of lymphoma.We presents three cases fromMacKay Memorial Hospital, illustrating the benefits and challenges associated with CAR T-cell therapy. In the first case, a 53-year-old female with B-acute lymphoblastic leukemia achieved CR after CAR T-cell therapy, with CAR T-cells detectable for at least six months. The second case involved a 49-year-old female with diffuse large B-cell lymphoma who experienced severe cytokine release syndrome (CRS) and ultimately passed away due to complications. The third case featured a 62-year-old male with mantle cell lymphoma, who initially responded to CAR T-cell therapy but later relapsed and succumbed to disease complications. The article emphasizes the importance of effective management of side effects such as CRS and neurotoxicity, which can significantly impact patient outcomes. Individualized management strategies are crucial. Future directions for CAR T-cell therapy include exploring next-generation constructs, alternative targets beyond CD19, and combining other treatment modalities. In conclusion, while CAR T-cell therapy represents a significant advancement, ongoing research is essential to optimize patient selection and management strategies.