Advances In the Use of CAR-T cell For the Treatment of Lymphoid Malignancies.

The introduction of Chimeric antigen receptor (CAR) T cells targeting CD19 represent one of the major advances in the treatment of lymphoma in the past 10 years. CAR-T cell therapy has become standard of care in the treatment of primary refractory or early relapsed diffuse large B-cell lymphoma (second line therapy) as well as for relapse after prior autologous stem cell transplant (Third line therapy). More than 40% of CAR-T recipients are surviving disease-free long-term and are potentially cured. CAR-T is also used for advanced low-grade lymphoma, multiple myeloma, acute lymphoblastic leukemia as well as other more experimental indications. CAR-T therapy is associated with specific short and long-term toxicities such as cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), myelosuppression, infections and possibly second malignancies. Treatment requires specific expertise and infra-structure.

Despite the extensive use of CAR-T, there are still challenges in treatment. Better understanding of resistance mechanism as well as prognostic factors for response is needed. Novel products as well as combination therapies are explored to increase efficacy and reduce toxicities. Practical issues such as more rapid availability and better use of medical resources are needed to expand treatment availability.

The scope of this Research Topic collection is to discuss recent advances in the use of CAR-T cells in the treatment of lymphoid malignancies. Both original reports and review articles are welcomed. Particular interest is in the following areas but not limited to:

- new indications

- Discussion of resistance mechanisms and prognostic factors and how they can be used for designing novel approaches to increase efficacy

- New methods for predicting and reducing treatment toxicity and future perspectives.

The Research Topic editors confirm that they have no conflicts of interest to declare in relation to the editorship of this collection.