肿瘤细胞治疗研究
英文原题：CAR T-cell therapy in acute myeloid leukemia.
CAR T-cell therapy in acute myeloid leukemia.
急性髓系白血病（AML）是一种侵袭性白血病，累及髓系祖细胞。
急性髓系白血病（AML）是一种侵袭性白血病恶性肿瘤，累及髓系祖细胞。复发或难治性 AML 患者预后仍然不佳，亟需开发新的治疗选择。采用嵌合抗原受体（CAR）的过继性 T 细胞治疗是白血病治疗领域一种引人关注的可能方案。目前正在开展临床试验（以 I 期和 II 期为主），评估靶向 CD33、CD123 和 CLL-1 等 AML 靶点的 CAR-T 细胞治疗。初步数据显示出良好前景。然而，由于 AML 在细胞和分子层面具有异质性，且部分 AML 靶点也在造血干细胞上共表达，这些临床研究出现了显著的“靶向脱瘤”毒性，提示仍需更多研究。本综述介绍 AML CAR-T 细胞治疗领域近期的重要突破，并讨论 CAR-T 技术的局限及克服这些挑战的未来方向。
Acute myeloid leukemia (AML) is an aggressive leukemic malignancy that affects myeloid lineage progenitors. Relapsed or refractory AML patients continue to have poor prognoses, necessitating the development of novel therapy alternatives. Adoptive T-cell therapy with chimeric antigen receptors (CARs) is an intriguing possibility in the field of leukemia treatment. Chimeric antigen receptor T-cell therapy is now being tested in clinical trials (mostly in phase I and phase II) using AML targets including CD33, CD123, and CLL-1. Preliminary data showed promising results. However, due to the cellular and molecular heterogeneity of AML and the co-expression of some AML targets on hematopoietic stem cells, these clinical investigations have shown substantial "on-target off-tumor" toxicities, indicating that more research is required. In this review, the latest significant breakthroughs in AML CAR T cell therapy are presented. Furthermore, the limitations of CAR T-cell technology and future directions to overcome these challenges are discussed.
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