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单倍体造血细胞移植作为 NK 细胞免疫治疗平台

英文原题:Haploidentical hematopoietic cell transplantation as a platform for natural killer cell immunotherapy.

查看英文原题

Haploidentical hematopoietic cell transplantation as a platform for natural killer cell immunotherapy.

PubMed 2024/09/09(内容时间) Am J Hematol Q1 · IF 9.4(JCR 2025)

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中文摘要

对于晚期血液系统恶性肿瘤患者,异基因造血细胞移植(HCT)后复发需要创新的管理方法。本综述探讨移植后使用环磷酰胺的半相合HCT关键特点,并阐述该平台用于自然杀伤(NK)细胞免疫治疗的潜力及适用性。NK细胞具有独特的癌细胞清除能力;经细胞因子激活后还可表现出类记忆特征和增强的细胞毒性。通过讨论临床试验的有希望结果,本文深入介绍近期重要进展:供者来源NK细胞可在体外大量扩增;细胞因子激活可能增强NK细胞在体内的持久性和疗效;HCT后输注NK细胞可改善高危和/或复发性髓系恶性肿瘤结局,且未增加移植物抗宿主病、严重细胞因子释放综合征或神经毒性风险。展望未来,可将细胞因子激活NK细胞与免疫调节药物联合,和/或通过基因工程增强其肿瘤靶向特异性、细胞毒性及持久性,同时预防耗竭。对这些策略的持续探索已显示初步前景,可能迅速转化为临床应用并使患者获益。

展开英文摘要原文

An innovative approach is crucially needed to manage relapse after allogeneic hematopoietic cell transplantation (HCT) in patients with advanced hematological malignancies. This review explores key aspects of haploidentical HCT with post-transplant cyclophosphamide, highlighting the potential and suitability of this platform for natural killer (NK) cell immunotherapy. NK cells, known for their unique abilities to eliminate cancer cells, can also exhibit memory-like features and enhanced cytotoxicity when activated by cytokines.

By discussing promising results from clinical trials, the review delves into the recent major advances: donor-derived NK cells can be expanded ex vivo in large numbers, cytokine activation may enhance NK cell persistence and efficacy in vivo, and post-HCT NK cell infusion can improve outcomes in high-risk and/or relapsed myeloid malignancies without increasing the risk of graft-versus-host disease, severe cytokine release syndrome, or neurotoxicity.

Looking ahead, cytokine-activated NK cells can be synergized with immunomodulatory agents and/or genetically engineered to enhance their tumor-targeting specificity, cytotoxicity, and persistence while preventing exhaustion. The ongoing exploration of these strategies holds promising preliminary results and could be rapidly translated into clinical applications for the benefit of the patients.

论文信息

作者
Duléry R、Piccinelli S、Beg MS、Jang JE、Romee R
单位
Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.United States
文献类型
综述
期刊
American journal of hematology2024 Dec
原文标识
PubMed 39248561 · DOI 10.1002/ajh.27471