Goethe University Hospital, Frankfurt, Germany.
Hematology Am Soc Hematol Educ Program. 2011;2011:243-9. doi: 10.1182/asheducation-2011.1.243.
A major breakthrough in the treatment of acute lymphoblastic leukemia (ALL) was the availability of targeted therapies targeting either specific transcripts, such as bcr-abl fusion protein by tyrosine kinase inhibitors (TKIs), or specific antigens by mAbs. ALL blast cells express a variety of specific antigens (eg, CD19, CD20, CD22, CD33, and CD52) that serve as targets for mAbs. To date, the most data are available for anti-CD20 (rituximab), which has been combined with chemotherapy for the treatment of mature B-ALL/Burkitt lymphoma. Studies with rituximab have also been completed in B-precursor ALL. Another antigen, CD19, is of great interest due to a very high rate of expression in ALL. It can be targeted by a bispecific mAb, blinatumomab, directed against CD19 and CD3. Smaller studies or case reports are also available for the anti-CD52 (alemtuzumab), anti-CD22 (epratuzumab), and anti-CD33 (gemtuzumab) mAbs. Available data demonstrate that mAb therapy in ALL is a highly promising treatment approach. However, several details for an optimal treatment approach, such as the required level of antigen expression, timing, schedule, dosage, and stage of disease, still need to be defined.
在急性淋巴细胞白血病 (ALL) 的治疗中取得的一项重大突破是，可获得针对特定转录本的靶向疗法，例如酪氨酸激酶抑制剂 (TKI) 针对 bcr-abl 融合蛋白，或单克隆抗体 (mAb) 针对特定抗原。ALL 白血病细胞表达多种特异性抗原（例如，CD19、CD20、CD22、CD33 和 CD52），这些抗原可作为 mAb 的靶标。迄今为止，抗 CD20（利妥昔单抗）的数据最多，已与化疗联合用于治疗成熟 B-ALL/伯基特淋巴瘤。在 B 前体 ALL 中也完成了利妥昔单抗的研究。另一个抗原 CD19 由于在 ALL 中表达率非常高而备受关注。它可以被针对 CD19 和 CD3 的双特异性 mAb，blinatumomab 靶向。也有较小的研究或病例报告可用于抗 CD52（阿仑单抗）、抗 CD22（epratuzumab）和抗 CD33（吉妥珠单抗）的 mAb。现有数据表明，mAb 疗法在 ALL 中是一种极具前景的治疗方法。然而，仍需要确定一些最佳治疗方法的细节，例如抗原表达所需的水平、时机、方案、剂量和疾病阶段。
