Barbanti Maria Chiara, Appleby Niamh, Kesavan Murali, Eyre Toby Andrew
Department of Clinical Haematology, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
Clinical Trials Unit, Department of Oncology, Churchill Hospital, Oxford University Hospitals NHS Trust, University of Oxford, Oxford, United Kingdom.
Front Oncol. 2022 Apr 28;12:888109. doi: 10.3389/fonc.2022.888109. eCollection 2022.
Despite the development of highly effective, targeted inhibitors of B-cell proliferation and anti-apoptotic pathways in chronic lymphocytic leukemia (CLL), these treatments are not curative, and many patients will develop either intolerance or resistance to these treatments. Transformation of CLL to high-grade lymphoma-the so-called Richter syndrome (RS)-remains a highly chemoimmunotherapy-resistant disease, with the transformation occurring following targeted inhibitors for CLL treatment being particularly adverse. In light of this, cellular therapy in the form of allogenic stem cell transplantation and chimeric antigen receptor T-cell therapy continues to be explored in these entities. We reviewed the current literature assessing these treatment modalities in both high-risk CLL and RS. We also discussed their current limitations and place in treatment algorithms.
尽管针对慢性淋巴细胞白血病（CLL）的B细胞增殖和抗凋亡途径开发了高效、靶向抑制剂，但这些治疗方法并非治愈性的，许多患者会对这些治疗产生不耐受或耐药性。CLL转化为高级别淋巴瘤——即所谓的里氏综合征（RS）——仍然是一种高度化疗免疫治疗耐药的疾病，在使用CLL治疗的靶向抑制剂后发生转化尤其不利。有鉴于此，同种异体干细胞移植和嵌合抗原受体T细胞疗法等细胞疗法仍在这些疾病中不断探索。我们回顾了评估这些治疗方式在高危CLL和RS中的当前文献。我们还讨论了它们目前的局限性以及在治疗方案中的地位。
