What question did this study set out to answer?

The review aims to summarize the efficacy, safety, and mechanisms of failure of CAR T-cell therapy in pediatric relapsed/refractory B-ALL.

April 3, 2026Open Access

CAR T-Cell Therapy in Pediatric Relapsed/Refractory B-Cell Acute Lymphoblastic Leukaemia: Efficacy, Safety, Mechanisms of Failure, Long-Term Outcomes, and Next-Generation Strategies — A Comprehensive Review (2023–2026)

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Comprehensive review evaluates CAR T-cell therapy effectiveness in pediatric B-ALL, highlighting treatment challenges and promising advancements.

The review aims to summarize the efficacy, safety, and mechanisms of failure of CAR T-cell therapy in pediatric relapsed/refractory B-ALL.
Conducted a structured narrative synthesis of diverse clinical data and systematic reviews.
Incorporated analysis from pivotal clinical trials and real-world registries.
Considered over 90 unique papers across different review modules.
CAR T-cells achieve complete remission and MRD-negativity rates over 80-86%.
1-year overall survival rates range from 72-77%.
Grade ≥3 cytokine release syndrome and neurotoxicity occur in 7-21% of cases, manageable with tocilizumab and corticosteroids.
Consolidative HSCT post-MRD-negative CR significantly improves 3-year OS to 58-76%.
Next-generation constructs are reducing challenges like antigen escape and persistence issues.

Tiwari et al. (2026) studied this question.

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Comprehensive review evaluates CAR T-cell therapy effectiveness in pediatric B-ALL, highlighting treatment challenges and promising advancements.