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嵌合抗原受体T细胞(CAR-T细胞)治疗T细胞急性淋巴细胞白血病/淋巴瘤的临床疗效与安全性

Clinical outcomes and safety of CAR-T cells in treatment of T-Cell acute lymphoblastic leukemia/lymphoma.

作者信息

Ma Jin-Feng, Yan Chun-Long, Jia Xu, Zhu Hong-Jia, Yan Jia-Wei, Liu Mei-Jing, Zhang Dai-Yi, Liu Shen-Hao, Xu Nan, Zhang Hai-Guo, Ye Ling, Yu Lei, Wu De-Pei, Gong Wen-Jie, Dai Hai-Ping, Xue Sheng-Li

机构信息

Jining No.1 People'hospital, Jining, China.

National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Ann Hematol. 2025 Jan;104(1):57-63. doi: 10.1007/s00277-024-06132-w. Epub 2024 Dec 18.

Abstract

Relapsed or refractory T-cell acute lymphoblastic leukemia/lymphoma (r/r T-ALL/LBL) are frequently aggressive and associated with unfavorable prognoses. Pan-targeted Chimeric Antigen Receptor (CAR) T-cell therapy have shown promising results in clinical trials. In recent years, CD7 CAR T-cell and CD5 CAR T-cell demonstrate effectiveness in treating r/r T-ALL/LBL patients with bone marrow infiltration. However, nearly half of r/r T-ALL/T-LBL patients are accompanied by extramedullary disease (EMD), where comprehensive data on the efficacy and safety of CAR T-cell therapy remain limited. Additionally, CD7 CAR T-cell and CD5 CAR T-cell therapy can cause severe immunodeficiency and hematologic toxicity, complicating with difficult immune reconstitution. This review provides an in-depth analysis of the safety profile and adverse events associated with CAR T-cell therapy in r/r T-ALL/LBL, with a a particular emphasis on its impact in patients with EMD.

摘要

复发或难治性T细胞急性淋巴细胞白血病/淋巴瘤(r/r T-ALL/LBL)通常具有侵袭性,预后不良。全靶向嵌合抗原受体(CAR)T细胞疗法在临床试验中已显示出有前景的结果。近年来,CD7 CAR T细胞和CD5 CAR T细胞在治疗有骨髓浸润的r/r T-ALL/LBL患者中显示出有效性。然而,近一半的r/r T-ALL/T-LBL患者伴有髓外疾病(EMD),关于CAR T细胞疗法疗效和安全性的全面数据仍然有限。此外,CD7 CAR T细胞和CD5 CAR T细胞疗法可导致严重免疫缺陷和血液学毒性,伴有免疫重建困难。本综述深入分析了r/r T-ALL/LBL中与CAR T细胞疗法相关的安全性和不良事件,特别强调其对EMD患者的影响。

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