Riva Carola, Vernarecci Chiara, Minetto Paola, Goda Rayan, Greppi Marco, Pesce Silvia, Chies Maria, Zecchetti Giada, Ferro Beatrice, Maio Elena, Cea Michele, Lemoli Roberto Massimo, Marcenaro Emanuela, Guolo Fabio
Clinic of Hematology, Department of Internal Medicine, University of Genova, 16132 Genova, Italy.
IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
J Clin Med. 2023 Sep 7;12(18):5824. doi: 10.3390/jcm12185824.
Despite the results achieved with the evolution of conventional chemotherapy and the inclusion of targeted therapies in the treatment of acute myeloid leukemia (AML), survival is still not satisfying, in particular in the setting of relapsed/refractory (R/R) disease or elderly/unfit patients. Among the most innovative therapeutic options, cellular therapy has shown great results in different hematological malignancies such as acute lymphoblastic leukemia and lymphomas, with several products already approved for clinical use. However, despite the great interest in also expanding the application of these new treatments to R/R AML, no product has been approved yet for clinical application. Furthermore, cellular therapy could indeed represent a powerful tool and an appealing alternative to allogeneic hematopoietic stem cell transplantation for ineligible patients. In this review, we aim to provide an overview of the most recent clinical research exploring the effectiveness of cellular therapy in AML, moving from consolidated approaches such as post- transplant donor's lymphocytes infusion, to modern adoptive immunotherapies such as alloreactive NK cell infusions, engineered T and NK cells (CAR-T, CAR-NK) and novel platforms of T and NK cells engaging (i.e., BiTEs, DARTs and ANKET).
尽管传统化疗不断发展，且在急性髓系白血病（AML）治疗中纳入了靶向治疗，但患者的生存率仍不尽人意，尤其是在复发/难治性（R/R）疾病或老年/身体状况不佳的患者中。在最具创新性的治疗选择中，细胞疗法已在不同的血液系统恶性肿瘤（如急性淋巴细胞白血病和淋巴瘤）中显示出显著效果，已有多种产品获批用于临床。然而，尽管人们对将这些新疗法扩展应用于R/R AML也抱有极大兴趣，但尚无产品获批用于临床。此外，对于不符合条件的患者，细胞疗法确实可能成为一种强大的工具，是异基因造血干细胞移植颇具吸引力的替代方案。在这篇综述中，我们旨在概述探索细胞疗法在AML中有效性的最新临床研究，内容涵盖从巩固治疗方法（如移植后供体淋巴细胞输注）到现代过继性免疫疗法（如同种异体反应性NK细胞输注、工程化T细胞和NK细胞（CAR-T、CAR-NK）以及新型T细胞和NK细胞接合平台（即双特异性T细胞衔接器、定向募集双特异性T细胞抗体和锚定细胞毒素））。
