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嵌合抗原受体T细胞在急性髓系白血病中的最新进展

Recent advances of CAR-T cells in acute myeloid leukemia.

作者信息

Deng Huan, Wang Qi, Tong Xiaodong, Cui Zhiwei, Yang Yang, Xiang Ying

机构信息

Department of Medical Laboratory, The People's Hospital of Leshan, No. 238, Baita Street, Shizhong District, Leshan, Sichuan 614000, China.

Department of Medical Records and Statistics Room, The People's Hospital of Leshan, Leshan, Sichuan, China.

出版信息

Ther Adv Hematol. 2025 Mar 25;16:20406207251326802. doi: 10.1177/20406207251326802. eCollection 2025.

Abstract

Acute myeloid leukemia (AML), the most common type of leukemia in adults, is a highly heterogeneous and aggressive hematologic malignancy. Since the 20th century, the combination of cytosine arabinoside and anthracyclines has been the most common chemotherapy drug used to treat patients with AML. Although, new targeted medicines have emerged, such as midostaurin and gilteritinib targeting FMS-like tyrosine kinase 3 (FLT3), ivosidenib (isocitrate dehydrogenase 1 (IDH1) inhibitor) and enasidenib (IDH2 inhibitor) targeting IDH, and gemtuzumab ozogamicin targeting CD33, which have changed the treatment strategies of AML. But, until now, hematopoietic stem cell transplantation remains the best treatment option in most cases. However, treatment resistance and relapse are still the major consequences of disease progression in AML, highlighting the urgent need for novel therapeutic approaches. As an alternative, chimeric antigen receptor (CAR)-T cells are engineered T-cells developed as a breakthrough in cancer therapy in recent years, and explored and used in various tumor types. In particular, it has achieved remarkable efficacy in the field of relapsed and refractory B lymphocyte tumors. This review mainly summarizes and discusses the research progress and the clinical application of CAR-T cell immunotherapy in AML in recent years.

摘要

急性髓系白血病(AML)是成人中最常见的白血病类型,是一种高度异质性且侵袭性的血液系统恶性肿瘤。自20世纪以来,阿糖胞苷和蒽环类药物联合使用一直是治疗AML患者最常用的化疗药物。尽管出现了新的靶向药物,如靶向FMS样酪氨酸激酶3(FLT3)的米哚妥林和吉列替尼、靶向异柠檬酸脱氢酶(IDH)的艾伏尼布(异柠檬酸脱氢酶1(IDH1)抑制剂)和恩西地平(IDH2抑制剂),以及靶向CD33的吉妥珠单抗奥唑米星,这些药物改变了AML的治疗策略。但是,直到现在,造血干细胞移植在大多数情况下仍然是最佳治疗选择。然而,治疗耐药和复发仍是AML疾病进展的主要后果,凸显了对新型治疗方法的迫切需求。作为一种替代方法,嵌合抗原受体(CAR)-T细胞是近年来作为癌症治疗突破而开发的工程化T细胞,并在各种肿瘤类型中进行了探索和应用。特别是,它在复发难治性B淋巴细胞肿瘤领域取得了显著疗效。本综述主要总结和讨论近年来CAR-T细胞免疫疗法在AML中的研究进展及临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a0a/11938459/8ec673b8a0e9/10.1177_20406207251326802-fig1.jpg

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