嵌合抗原受体 T 细胞疗法在 B 细胞淋巴瘤患者中面临的挑战。

Current Challenges in Chimeric Antigen Receptor T-cell Therapy in Patients With B-cell Lymphoid Malignancies.

机构信息

Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Ann Lab Med. 2024 May 1;44(3):210-221. doi: 10.3343/alm.2023.0388. Epub 2024 Jan 11.

Abstract

Chimeric antigen receptor (CAR) T-cell therapy is a promising immunotherapy based on genetically engineered T cells derived from patients. The introduction of CAR T-cell therapy has changed the treatment paradigm of patients with B-cell lymphoid malignancies. However, challenging issues including managing life-threatening toxicities related to CAR T-cell infusion and resistance to CAR T-cell therapy, leading to progression or relapse, remain. This review summarizes the issues with currently approved CAR T-cell therapies for patients with relapsed or refractory B-cell lymphoid malignancies, including lymphoma and myeloma. We focus on unique toxicities after CAR T-cell therapy, such as cytokine-related events and hematological toxicities, and the mechanisms underlying post-CAR T-cell failure.

摘要

嵌合抗原受体 (CAR) T 细胞疗法是一种有前途的免疫疗法,基于从患者中获得的基因工程 T 细胞。CAR T 细胞疗法的引入改变了 B 细胞淋巴样恶性肿瘤患者的治疗模式。然而,仍存在一些挑战性问题,包括管理与 CAR T 细胞输注相关的危及生命的毒性和对 CAR T 细胞治疗的耐药性,导致疾病进展或复发。本综述总结了目前批准的用于治疗复发或难治性 B 细胞淋巴样恶性肿瘤患者(包括淋巴瘤和骨髓瘤)的 CAR T 细胞疗法的问题。我们重点关注 CAR T 细胞治疗后的独特毒性,如细胞因子相关事件和血液学毒性,以及 CAR T 细胞治疗失败的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f76e/10813822/d2fba978dfef/alm-44-3-210-f1.jpg

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