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[急性淋巴细胞白血病的抗体治疗]

[Antibody therapy for acute lymphoblastic leukemia].

作者信息

Hatta Yoshihiro

机构信息

Division of Hematology and Rheumatology, Nihon University School of Medicine.

出版信息

Rinsho Ketsueki. 2020;61(8):922-928. doi: 10.11406/rinketsu.61.922.

Abstract

In 2018, two novel antibody therapies, inotuzumab ozogamicin (InO) and blinatumomab, against relapsed or refractory acute lymphoblastic leukemia were approved in Japan. In InO, the antitumor drug ozogamicin is conjugated to the anti-CD22 antibody. Blinatumomab is a bispecific T cell engager antibody comprising the variable regions of the anti-CD19 and the anti-CD3 antibodies. The remission rate of InO is about 75%; however, the frequency of sinusoidal obstruction syndrome is increased when allogeneic hematopoietic cell transplantation is performed after InO treatment. Blinatumomab has a remission rate of 45-70%. The management of cytokine release syndrome during blinatumomab treatment is required in certain cases. Although both the treatments have higher remission and negativity of minimal residual disease rates compared to those in conventional chemotherapy, it is difficult to maintain remission in the long term. Allogeneic hematopoietic stem cell transplantation should be performed as commonly as possible.

摘要

2018年,两种新型抗体疗法——吉妥珠单抗奥唑米星(InO)和博纳吐单抗,被批准用于治疗日本复发或难治性急性淋巴细胞白血病。在InO中,抗肿瘤药物奥唑米星与抗CD22抗体偶联。博纳吐单抗是一种双特异性T细胞衔接抗体,由抗CD19抗体和抗CD3抗体的可变区组成。InO的缓解率约为75%;然而,在InO治疗后进行异基因造血细胞移植时,肝窦阻塞综合征的发生率会增加。博纳吐单抗的缓解率为45%-70%。在某些情况下,需要对博纳吐单抗治疗期间的细胞因子释放综合征进行管理。尽管与传统化疗相比,这两种疗法都有更高的缓解率和更低的微小残留病率,但长期维持缓解仍很困难。应尽可能常规进行异基因造血干细胞移植。

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