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中国靶向治疗时代的造血干细胞移植:当前的进展、挑战和未来方向。

Haematopoietic stem-cell transplantation in China in the era of targeted therapies: current advances, challenges, and future directions.

机构信息

Peking University People's Hospital and Institute of Hematology, Peking University, Beijing, China; National Clinical Research Center for Hematologic Disease, Beijing, China; Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.

Peking University People's Hospital and Institute of Hematology, Peking University, Beijing, China; National Clinical Research Center for Hematologic Disease, Beijing, China; Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China; Peking-Tsinghua Center for Life Sciences, Beijing, China.

出版信息

Lancet Haematol. 2022 Dec;9(12):e919-e929. doi: 10.1016/S2352-3026(22)00293-9.

Abstract

In the era of targeted therapies, haematopoietic stem-cell transplantation (HSCT), both allogeneic and autologous, remains a curative approach for patients with chemosensitive and immunesensitive malignant and non-malignant haematological disease in China. Since 2000, we have seen a substantial increase in the number of HSCTs, especially haploidentical HSCT, in patients with acute leukaemia and severe aplastic anaemia. Haploidentical donors have been the most common allograft donors in China since 2013. Key components of allogeneic HSCT include best donor selection for acute leukaemia, incorporation of target therapy, especially chimeric antigen receptor T cells, allografts for acute leukaemia outcome improvement, total therapy for relapsed or refractory acute leukaemia and haploidentical allografts as upfront therapy for severe aplastic anaemia. Despite many challenges in the HSCT setting in China, such as how to redefine the roadmap for HSCT, improve the health-related quality of life of long-term surviving transplant recipients, and promote national and international collaboration, allogeneic HSCT and autologous HSCT will continue to have an important role in treating diverse diseases between now and 2050. The development of HSCT in China will contribute to the worldwide development of HSCT.

摘要

在靶向治疗时代,异基因造血干细胞移植(HSCT)和自体 HSCT 仍然是中国对化疗敏感和免疫敏感的恶性和非恶性血液病患者的一种治愈方法。自 2000 年以来,我们看到 HSCT 数量大幅增加,尤其是在急性白血病和严重再生障碍性贫血患者中。自 2013 年以来,单倍体供者一直是中国最常见的同种异体供者。异基因 HSCT 的关键组成部分包括急性白血病的最佳供者选择、纳入靶向治疗,特别是嵌合抗原受体 T 细胞、改善急性白血病移植结局的同种异体移植物、复发或难治性急性白血病的总治疗以及作为严重再生障碍性贫血一线治疗的单倍体同种异体移植物。尽管中国 HSCT 领域存在许多挑战,例如如何重新定义 HSCT 路线图、提高长期生存移植受者的健康相关生活质量以及促进国内外合作,但异基因 HSCT 和自体 HSCT 将继续在 2050 年前治疗各种疾病方面发挥重要作用。中国 HSCT 的发展将有助于全球 HSCT 的发展。

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