CAR-T（CAR-T）细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T（CAR-T）细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
CAR-T 细胞治疗后序贯异基因造血干细胞移植在 Ph 样 ALL 与其他高危 ALL 中取得相当结局
英文原题：CAR-T cell therapy followed by allogenic hematopoietic stem cell transplantation yielded comparable outcome between Ph like ALL and other high-risk ALL.
查看英文原题
CAR-T cell therapy followed by allogenic hematopoietic stem cell transplantation yielded comparable outcome between Ph like ALL and other high-risk ALL.
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中文摘要
既往认为，Ph样ALL患者由于对常规化疗耐药且缺乏靶向药物，预后较其他B-ALL亚组更差。CAR-T 疗法已成功用于治疗复发/难治性B-ALL。目前关于CAR-T 疗法能否改变Ph样ALL结局的数据较少。
本研究纳入17名Ph样、23名Ph⁺及51名其他B-ALL患者，所有患者均接受自体CAR-T 细胞治疗，随后接受异基因干细胞移植。Ph样组和其他B-ALL组患者年龄均低于Ph⁺组（P=0.001）。Ph样和Ph⁺ ALL患者诊断时白细胞计数较高（P=0.025）。接受CAR-T 细胞输注前有活动性疾病的患者比例，在Ph样、Ph⁺和其他B-ALL组分别为64.7%、39.1%和62.7%。CAR-T 治疗缓解率分别为94.1%（16/17）、95.6%（22/23）和98.0%（50/51）。MRD阴性CR率分别为64.7%（11/17）、60.9%（14/23）和54.9%（28/51）。
Ph样、Ph⁺和其他B-ALL组估计3年总生存率分别为65.9%±16.5%、59.7%±10.5%和61.6%±7.3%（P=0.758）；3年无复发生存率分别为59.8%±14.8%、63.1%±10.5%和56.3%±7.1%（P=0.764），组间相近。估计3年累积复发率分别为7.8%±0.6%、23.4%±0.9%和29.0%±0.4%（P=0.241）。研究结果提示，CAR-T 序贯异基因HSCT可使Ph样ALL和其他高危B-ALL患者获得相近预后。试验注册：ClinicalTrials.gov，NCT03275493（2017年9月7日注册，前瞻性注册）和NCT03614858（2018年8月3日注册，前瞻性注册）。
展开英文摘要原文
It was previously believed that patients with Ph-like ALL had poorer prognosis compared with other B-ALL subgroups due to resistance to conventional chemotherapy and lack of targeted drugs. CAR-T therapy has been successfully applied in the treatment of relapsed and refractory B-ALL. Currently, there are few data on whether CAR-T therapy can alter the outcome of Ph-like ALL.
Here we included 17 Ph-like, 23 Ph+ and 51 other B-ALL patients, who received autologous CAR T-cell therapy and subsequently allogenic stem cell transplantation. Patients in the Ph-like group and B-ALL-others group were younger that those in the Ph+ group (P=0. 001). Ph-like and Ph+ ALL patients showed higher white blood cell counts at diagnosis (P=0. 025). The percentage of patients with active disease before receiving CAR T-cells infusion was 64. 7%, 39. 1% and 62. 7% in the Ph-like, Ph+ and B-ALL-others groups. The response rates to CAR-T therapy were 94. 1% (16/17), 95.
6% (22/23) and 98. 0% (50/51) in the Ph-like, Ph+ and B-ALL-others groups. Measurable residual disease negative CR was achieved in 64. 7% (11/17), 60. 9% (14/23) and 54. 9% (28/51) in the Ph-like, Ph+ and B-ALL-others groups, respectively. The estimated rates of 3-year overall survival (65. 9% 16.
5%, 59. 7% 10. 5% and 61. 6% 7. 3%, P=0. 758) and 3-year relapse-free survival (59. 8% 14. 8%, 63. 1% 10. 5% and 56. 3% 7. 1%, P=0. 764) were comparable among the Ph-like, Ph+ and B-ALL-others groups. Estimated 3-year cumulative relapse rate was 7. 8% 0. 6%, 23. 4% 0. 9% and 29. 0% 0. 4% (P=0. 241).
Our findings suggest that CART followed by allo-HSCT results in a comparable prognosis in Ph-like ALL and other high-risk B-ALL. Trial registration ClinicalTrials. gov, NCT03275493, Registered on September 7, 2017, prospectively registered and NCT03614858, Registered on August 3, 2018, prospectively registered.
论文信息
- 作者
- Dai HP、Kong DQ、Shen HJ、Cui W、Wang Q、Li Z、Yin J、Kang LQ
- 第一作者单位
- The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, 215006, China.China
- 通讯作者单位
- The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, 215006, China. xwtang1020@163.com.China
- 文献类型
- 读者来信
- 期刊
- Biomarker research2023 Feb 15
- 原文标识
- PubMed 36793095 · DOI 10.1186/s40364-023-00451-2
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