Hazane Leroyer Esther, Ziegler Caroline, Moulin Charline, Campidelli Arnaud, Jacquet Caroline, Rubio Marie Thérèse, Feugier Pierre, Pagliuca Simona
Service d'Hématologie Clinique, Hôpital Brabois, Centre Hospitalier Regional Universitaire de Nancy, 54500 Vandoeuvre les Nancy, France.
CNRS UMR 7365 IMoPa, Biopole de l'Université de Lorraine, 54505 Vandoeuvre les Nancy, France.
J Clin Med. 2022 Nov 6;11(21):6574. doi: 10.3390/jcm11216574.
Despite years of clinical progress which made Hodgkin lymphoma (HL) one of the most curable malignancies with conventional chemotherapy, refractoriness and recurrence may still affect up to 20-30% of patients. The revolution brought by the advent of immunotherapy in all kinds of neoplastic disorders is more than evident in this disease because anti-CD30 antibodies and checkpoint inhibitors have been able to rescue patients previously remaining without therapeutic options. Autologous hematopoietic cell transplantation still represents a significant step in the treatment algorithm for chemosensitive HL; however, the possibility to induce complete responses after allogeneic transplant procedures in patients receiving reduced-intensity conditioning regimens informs on its sensitivity to immunological control. Furthermore, the investigational application of adoptive T cell transfer therapies paves the way for future indications in this setting. Here, we seek to provide a fresh and up-to-date overview of the new immunotherapeutic agents dominating the scene of relapsed/refractory HL. In this optic, we will also review all the potential molecular mechanisms of tumor resistance, theoretically responsible for treatment failures, and we will discuss the place of allogeneic stem cell transplantation in the era of novel therapies.
尽管多年来的临床进展使霍奇金淋巴瘤(HL)成为传统化疗最可治愈的恶性肿瘤之一,但难治性和复发仍可能影响高达20%-30%的患者。免疫疗法在各种肿瘤疾病中带来的变革在这种疾病中表现得尤为明显,因为抗CD30抗体和检查点抑制剂能够挽救那些之前没有治疗选择的患者。自体造血细胞移植仍然是化疗敏感型HL治疗方案中的重要一步;然而,在接受降低强度预处理方案的患者中,异基因移植程序后诱导完全缓解的可能性表明了其对免疫控制的敏感性。此外,过继性T细胞转移疗法的研究应用为该领域未来的适应证铺平了道路。在此,我们试图对主导复发/难治性HL领域的新型免疫治疗药物提供一个全新的最新概述。从这个角度来看,我们还将回顾肿瘤耐药的所有潜在分子机制,理论上这些机制是治疗失败的原因,并且我们将讨论异基因干细胞移植在新疗法时代的地位。