Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA.
Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA.
Mol Ther. 2021 Feb 3;29(2):433-441. doi: 10.1016/j.ymthe.2020.10.022. Epub 2020 Oct 31.
Large B cell lymphoma (LBCL) is curable with standard chemo-immunotherapy in the majority of cases. However, patients with primary refractory or relapsed disease have historically had limited treatment options. Two gene-modified chimeric antigen receptor (CAR)-T cell therapies have now been approved for these indications. The clinical decisions and management surrounding these gene-modified "living drugs" are nuanced and complex. In this article, we discuss the evolving evidence supporting the use of these CAR-T cells, including patient selection, screening procedures, special populations, bridging therapy, lymphodepletion, clinical management, relapse, and follow up.
大 B 细胞淋巴瘤（LBCL）在大多数情况下可通过标准的化疗免疫治疗治愈。然而，既往原发性难治或复发疾病患者的治疗选择有限。目前已有两种基因修饰嵌合抗原受体（CAR）-T 细胞疗法获批用于这些适应证。这些基因修饰的“活药物”的临床决策和管理非常复杂。本文讨论了支持使用这些 CAR-T 细胞的不断发展的证据，包括患者选择、筛选程序、特殊人群、桥接治疗、淋巴细胞耗竭、临床管理、复发和随访。
