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优化成人 B 细胞急性淋巴细胞白血病中的 CAR-T 细胞治疗

英文原题:Optimizing CAR-T cell therapy in adults with B-cell acute lymphoblastic leukemia.

查看英文原题

Optimizing CAR-T cell therapy in adults with B-cell acute lymphoblastic leukemia.

PubMed 2023/09/29(内容时间) Eur J Haematol Q2 · IF 2.6(JCR 2025)

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中文摘要

CAR-T 细胞疗法在多种血液系统恶性肿瘤中取得前所未有的成功,包括复发/难治性(R/R)B细胞急性淋巴细胞白血病(B-ALL)。目前,美国食品药品监督管理局(FDA)已批准两种用于成人R/R B-ALL的CD19靶向CAR-T 产品。尽管CD19 CAR-T 治疗R/R B-ALL后的缓解率较高,多数成人患者的缓解持续时间仍有限;若不进一步接受巩固治疗,复发十分常见。此外,成人R/R B-ALL患者的CAR-T 治疗毒性负担仍然显著,限制了这种有效疗法的广泛应用。本文综述与R/R B-ALL患者CAR-T 疗效相关的患者及疾病因素,并讨论提高缓解持久性、降低复发风险和减轻成人患者毒性的策略,同时介绍正在探索的进一步提高CAR-T 治疗成人B-ALL获益的方法。

展开英文摘要原文

Chimeric antigen receptor T-cell (CAR-T) therapy has demonstrated unprecedented success in the treatment of various hematologic malignancies including relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL).

Currently, there are two FDA-approved CD19-directed CAR-T cell products for the treatment of adults with R/R B-ALL. Despite high remission rates following CD19 CAR-T cell therapy in R/R B-ALL, remission durability remains limited in most adult patients, with relapse observed frequently in the absence of additional consolidation therapy.

Furthermore, the burden of CAR-T cell toxicity remains significant in adults with R/R B-ALL and further limits the wide utilization of this effective therapy. In this review, we discuss patient and disease factors that are linked to CAR-T cell therapy outcomes in R/R B-ALL and strategies to optimize durability of response to reduce relapse and mitigate toxicity in the adult population.

We additionally discuss future approaches being explored to maximize the benefit of CAR-T in adults with B-ALL.

论文信息

作者
Agrawal V、Murphy L、Pourhassan H、Pullarkat V、Aldoss I
单位
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA.United States
文献类型
综述
期刊
European journal of haematology2024 Feb
原文标识
PubMed 37772976 · DOI 10.1111/ejh.14109