Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Acta Haematol. 2024;147(1):99-112. doi: 10.1159/000534341. Epub 2023 Oct 9.
Chronic lymphocytic leukemia (CLL) is a heterogeneous B-cell malignancy, affecting mainly older adults. Despite the recent introduction of multiple targeted agents, CLL remains an incurable disease. Cellular therapy is a promptly evolving area that has developed over the last decades from such standard of care as hematopoietic cell transplantation (HCT) to the novel treatment modalities employing genetically engineered immune cells.
Tailoring the proper treatment for each patient is warranted and should take into account the disease biology, patient characteristics, and the available treatment modalities. Nowadays, the most broadly applied cellular therapies for CLL management are HCT and chimeric antigen receptor-T (CAR-T) cells. However, CAR-T cell therapy is currently not yet approved in CLL, and the appropriate sequencing for the administration of these agents remains to be clarified.
The current review will discuss various available cellular treatment options, their advances and limitations, as well as the optimal timing for the employment of such therapies in CLL patients.
慢性淋巴细胞白血病(CLL)是一种异质性 B 细胞恶性肿瘤,主要影响老年人。尽管最近引入了多种靶向药物,但 CLL 仍然是一种无法治愈的疾病。细胞疗法是一个迅速发展的领域,在过去几十年中,从造血细胞移植(HCT)等标准治疗方法发展到了利用基因工程免疫细胞的新型治疗方式。
为每个患者量身定制适当的治疗方案是必要的,应考虑疾病生物学、患者特征和可用的治疗方式。目前,最广泛应用于 CLL 管理的细胞疗法是 HCT 和嵌合抗原受体-T(CAR-T)细胞。然而,CAR-T 细胞疗法目前尚未在 CLL 中获得批准,这些药物的给药顺序仍有待阐明。
本综述将讨论各种可用的细胞治疗选择,以及它们的进展和局限性,以及在 CLL 患者中使用这些疗法的最佳时机。