Progress and Challenges in the Application of CAR T-Cell Therapy for Hematologic Malignancies

With an aging population and changes in environmental and lifestyle factors, the incidence of hematologic malignancies has been increasing worldwide. Diseases such as leukemia, lymphoma, and multiple myeloma are often characterized by rapid progression and high relapse rates, posing a serious threat to human health. Conventional treatment modalities, including chemotherapy, radiotherapy, and transplantation of hematopoietic stem cells, have demonstrated limited efficacy among individuals with relapsed or refractory hematologic malignancies. Drug resistance, low remission rates, and poor prognosis remain major clinical concerns, underscoring the pressing demand for innovative therapeutic approaches capable of addressing the limitations of current treatments. Chimeric antigen receptor T-cell (CAR T-cell) therapy is widely regarded as a significant advancement in the field of cancer immunotherapy. Owing to its precise targeting and potent antitumor activity, CAR T-cell therapy has provided a novel treatment option for individuals affected by relapsed or refractory hematologic malignancies. Based on relevant literature review and inductive analysis, this review offers a comprehensive overview of recent progress regarding the clinical use of CAR T-cell therapy for a range of hematologic malignancies. It focuses on the major challenges associated with clinical application, particularly cytokine release syndrome, tumor immune evasion, and high treatment costs. In addition, current technological improvements and clinical optimization strategies are discussed, and future development trends are explored. Existing evidence indicates that, compared with conventional treatment modalities, CAR T-cell therapy provides clinically meaningful benefits for individuals with relapsed or refractory hematologic malignancies. It can improve remission rates and clinical outcomes and therefore has considerable clinical value. However, several limitations remain, including the risk of serious adverse events, tumor immune evasion, and high costs, all of which substantially hinder its clinical translation and widespread application.