Core Insights - The article highlights the revolutionary impact of CAR-T therapy in treating adult relapsed acute B lymphoblastic leukemia (B-ALL), showcasing a successful case where a patient achieved complete remission after treatment [1][4][7] Group 1: CAR-T Therapy Development - The first CAR-T therapy for adult relapsed B-ALL in China, "Nakiolun", was approved in 2023, filling a significant gap in immunotherapy options for this patient population [2][4] - CAR-T therapy has shown high efficacy, with a reported objective response rate (ORR) of 82.1% and a minimal residual disease (MRD) negative rate of 100% within three months of treatment [4][6] Group 2: Patient Outcomes and Survival Rates - Adult patients with relapsed B-ALL have a median overall survival of only 2-6 months, with a 5-year survival rate below 10% [3][6] - CAR-T therapy offers a promising alternative, as evidenced by a patient who, after traditional treatments failed, achieved long-term remission through CAR-T, highlighting its potential to improve survival outcomes significantly [3][7] Group 3: Challenges and Future Directions - Despite its effectiveness, CAR-T therapy faces challenges such as being used only as a last resort after exhausting other treatment options and its high cost, approximately 1.2 million yuan (around 120,000 USD) [6][7] - There is a clinical ambition to reposition CAR-T therapy from a last-line treatment to an earlier intervention for patients with first relapse or MRD positivity, which could potentially replace traditional stem cell transplants [7]