Application and challenges of chimeric antigen receptor T cell therapy in the treatment of acute myeloid leukemia (Review).

Chimeric antigen receptor (CAR) T cell therapy is a rapidly evolving form of targeted immunotherapy that merges the antigen-recognition specificity of monoclonal antibodies with the potent cytotoxic function of T cells. While it has achieved remarkable clinical success in B cell hematologic malignancies, its application to acute myeloid leukemia (AML) remains limited by several key obstacles. These include the absence of AML-specific antigens, antigen escape, an immunosuppressive tumor microenvironment and pronounced intratumoral heterogeneity. Together, these challenges substantially hinder the efficacy and safety of CAR-T cell therapy in AML. The present review provides a comprehensive overview of current advancements in CAR-T cell therapy for AML, with particular emphasis on strategies to overcome existing barriers such as improved target antigen selection, CAR structural optimization and modulation of the tumor microenvironment. These insights aim to inform the development of next-generation CAR-T therapies with enhanced precision, persistence and therapeutic benefit in AML.