**7. CAR T-cell therapy**

In fact, the new therapeutic progress of chimeric antigen receptor T cell is simultaneously a genetically, mechanically, and cellular therapy. This technique changed the leukocytes of the patient in such a way that they could identify and destroy the cancer cells. Despite a number of side effects, CAR T-Cell therapy will be effective for most patients who do not accept any other treatment or in relapses.

The purpose of CAR creation is to attack specific target molecules on the surface of cancer cells. They are usually antigens CD19 and CD22, which are designated for malignant cells in leukemia and lymphoma. It is very important that there are no similar molecules on the surface of healthy cells. The patient's own T cells are designed to show antigen receptors as "warheads" to focus on and assault tumor cells tumor cells when infused back into the patient. At the point when T cells perceive their target, they are activated, prompting the release of natural killer cells, cytokines, cytotoxic T lymphocytes, and other effector components.

The test of these engineered cells is to avoid inhibitor and suppressive signals from regulatory immune cells, the target cells, and the tumor microenvironment. It is beneficial to make reference to that CAR-T cell can recognize potential antigens in almost all structures including lipid, carbohydrate and protein antigens, which can be joined explicitly by antibodies [36, 37].

To make a situation where the CAR T cells will be respected, the patient experiences lymphodepleting treatment with fludarabine and cyclophosphamide. A couple of days after the fact, the T-cell item is transfused into the patient, where CD8+ and CD4+ cells will extend and endure until the tumor is dispensed with. Whenever effective, this procedure prompts long-term remission [38, 39].

In August 2017, a number of large clinical trials of the new cancer treatment technique, CAR T-cell, were completed. According to their findings, two drugs were approved by FDA: tisagenlecleucel (Kymriah) and as the first synthetic therapy for relapsed or refractory B- ALL and the second product of CAR T-cell therapy is axicabtagene ciloleucel (Yescarta), as immunotherapy for adults patients whose large cell lymphoma in refractory or relapsed on other therapies, including high-grade large cell lymphoma (mediastinal or transformed from follicular lymphoma) [38].

The improvement method of treatment with of CAR T cell therapy requires experience in many areas, including biology, molecular biology, antibody technology, regulatory requirements, and more. Increasing collaboration among key specialists from universities, research centers, and stakeholders will enhance the success of these drugs [39].

## **8. Bone marrow transplantation**

Bone marrow transplantation is an important branch and important indicator of the treatment model of hematologic malignancies. Hematopoietic stem cell transplantation (HSCT) has been included in therapeutic guidelines for most malignant tumors [40]. For those diseases that can be treated by a conventional therapy, how many of the acute leukemia and aggressive lymphomas and allogeneic BMT they are often the preferred treatment, if the initial relapse. For hematologic malignancies curable with a conventional therapy, such as multiple myeloma, myelodysplastic syndromes and low-grade lymphoma and acute leukemia poor risk, usually the treatment will be allogeneic BMT treatment at the time survival duration is felt to be relatively short.
