决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:EBV-associated NK and T-cell lymphoid neoplasms.
EBV-associated NK and T-cell lymphoid neoplasms.
已描述结外NK/T细胞淋巴瘤(ENKTCL)的不同分子亚型,其在起源细胞、EBV模式、基因组改变、临床特征、对基于天冬酰胺酶疗法的反应以及对近期针对淋巴瘤分子异常的方法的反应方面存在差异。在过去二十年中,ENKTCL临床管理的进展基于含L-天冬酰胺酶的联合方案以及放疗的整合。一部分具有PDL1-2结构改变的病例可能对免疫检查点抑制剂治疗更敏感。来源于T或NK细胞的原发性结内EBV+淋巴瘤具有独特特征,使其既不同于外周T细胞淋巴瘤非特指型,也不同于ENKTCL。治疗算法与晚期ENKTCL相对应。
EBV相关的NK或T细胞来源肿瘤是一组影响儿童和成人的临床和生物学异质性疾病,总体罕见,但在亚洲和南美洲更为普遍。本综述聚焦于成人期发病的肿瘤,探讨这些高度侵袭性疾病的最新基因组发现及治疗进展。
已描述结外NK/T细胞淋巴瘤(ENKTCL)的不同分子亚型,其在起源细胞、EBV模式、基因组改变、临床特征、对基于天冬酰胺酶疗法的反应以及对近期针对淋巴瘤分子异常的方法的反应方面存在差异。在过去二十年中,ENKTCL临床管理的进展基于含L-天冬酰胺酶的联合方案以及放疗的整合。一部分具有PDL1-2结构改变的病例可能对免疫检查点抑制剂治疗更敏感。来源于T或NK细胞的原发性结内EBV+淋巴瘤具有独特特征,使其既不同于外周T细胞淋巴瘤非特指型,也不同于ENKTCL。治疗算法与晚期ENKTCL相对应。总结:随着对淋巴瘤发生、基因组景观和疾病免疫学方面的更好理解,未来的治疗选择将包括靶向治疗,包括免疫检查点抑制剂和新型抗体。
PURPOSE OF REVIEW: Epstein-Barr virus (EBV)-associated neoplasms derived from natural killer (NK) or T cells comprise a group of clinically and biologically heterogenous disorders affecting children and adults, which are overall rare but more prevalent in Asia and South America. This review focuses on neoplasms presenting in the adulthood, addressing recent genomic discoveries as well as therapeutic developments in these highly aggressive disorders. RECENT FINDINGS: Distinct molecular subtypes of extranodal NK/T-cell lymphomas (ENKTCLs) have been described, with differences in cell of origin, EBV pattern, genomic alterations, clinical characteristics, response to asparaginase-based therapies and to more recent approaches targeting molecular aberrations of the lymphoma. For the last two decades, progress in the clinical management of ENKTCL was based on L-asapraginase containing combinations and the incoroperation of radiotherapy. A subset of cases with PDL1-2 structural alterations may be more responsive to treatment with immune checkpoint inhibitors. Primary nodal EBV+ lymphomas derived from T or NK cells have distinctive features separating them from both peripheral T-cell lymphoma not otherwise specified and ENKTCL. Treatment algorithms correspond to those for advanced ENKTCL. SUMMARY: With better understanding of lymphomagenesis, genomic landscape and immunologic aspects of the diseases, future treatment options will include targeted therapies including immune checkpoint inhibitors and novel antibodies.
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