B 急性淋巴细胞白血病中的嵌合抗原受体 T 细胞：现状与未来方向
Chimeric Antigen Receptor T-Cells in B-Acute Lymphoblastic Leukemia: State of the Art and Future Directions.
作者信息
Greenbaum Uri, Mahadeo Kris Michael, Kebriaei Partow, Shpall Elizabeth J, Saini Neeraj Y
机构信息
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
出版信息
Front Oncol. 2020 Aug 26;10:1594. doi: 10.3389/fonc.2020.01594. eCollection 2020.
Abstract
Use of adoptive T-cell therapy modified with chimeric antigen receptor (CAR-T) has revolutionized treatment of patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL). CAR-T cells directed against CD19 antigen have produced response rates as high as 90% in clinical trials for r/r B-ALL. Despite high rates of complete remissions, the durability of responses has been sub-optimal with frequent relapses, especially in adult B-ALL population. Systemic toxicities from CAR-T therapy and standardization of toxicities grading and management is another major hurdle in the development of CAR-T field. In this review, we discuss the latest evidence of CAR-T therapy in B-ALL, potential mechanisms of relapse and barriers to CAR-T cell therapy in B-ALL. We also debate the role of allogeneic hematopoietic stem cell transplant (allo-HCT) post CAR-T therapy.
摘要
嵌合抗原受体（CAR-T）修饰的过继性T细胞疗法的应用彻底改变了复发/难治性（r/r）B细胞急性淋巴细胞白血病（B-ALL）患者的治疗方式。针对CD19抗原的CAR-T细胞在r/r B-ALL的临床试验中产生了高达90%的缓解率。尽管完全缓解率很高，但缓解的持久性并不理想，复发频繁，尤其是在成人B-ALL患者群体中。CAR-T疗法的全身毒性以及毒性分级和管理的标准化是CAR-T领域发展的另一个主要障碍。在本综述中，我们讨论了CAR-T疗法治疗B-ALL的最新证据、复发的潜在机制以及B-ALL中CAR-T细胞疗法的障碍。我们还探讨了CAR-T治疗后异基因造血干细胞移植（allo-HCT）的作用。
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