肿瘤细胞治疗研究
英文原题：Adoptive Cellular Therapy in Acute Myeloid Leukemia: Current Scope and Challenges.
过继性细胞疗法已经革新了血液系统恶性肿瘤的治疗，尤其是淋巴瘤和多发性骨髓瘤。
过继细胞疗法已彻底改变血液系统恶性肿瘤的治疗，尤其是淋巴瘤和多发性骨髓瘤。此类疗法靶向疾病特异性抗原，例如淋巴瘤中的CD19和多发性骨髓瘤中的B细胞成熟抗原；与传统化疗相比，疗效好且耐受性良好。遗憾的是，这类疗法在急性髓系白血病（AML）中的潜力尚未实现，因为AML细胞上大多数可靶向抗原也表达于健康的髓系造血干细胞（HSC），靶向这些抗原会造成严重骨髓消融和全血细胞减少。研究者已提出多种克服这一障碍的策略，包括鉴定AML特异性抗原、限制CAR-T细胞持续存在以避免长期骨髓消融，以及在异基因移植前改造HSC以产生AML特异性抗原。本文讨论这些策略及AML过继细胞疗法的在研临床试验，重点介绍CAR-T 细胞和嵌合抗原受体NK 细胞（CAR-NK）。
Adoptive cellular therapies have revolutionized the management of hematologic malignancies, particularly lymphoma and multiple myeloma. These therapies targeting disease-specific antigens, such as CD19 in lymphoma and B cell maturation antigen in multiple myeloma, are efficacious and well-tolerated compared with conventional chemotherapies. Unfortunately, their potential remains unrealized in acute myeloid leukemia (AML). This is because most targetable antigens on AML cells are also expressed on healthy myeloid hematopoietic stem cells (HSC). Therefore, targeting them results in severe myeloablative effects and pancytopenia. Several strategies have been devised to overcome this barrier, including identifying AML-specific antigens, limiting CAR-T cell persistence to prevent prolonged myeloablation, and creating AML-specific antigens through manipulating HSCs prior to allogenic transplant. In this review, we discuss these strategies and the ongoing clinical trials on adoptive cellular therapies in AML, limiting our focus to chimeric antigen receptor-T cells (CAR-T) and chimeric antigen receptor-natural killer cells (CAR-NK).
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