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Ph- 急性淋巴细胞白血病:一线治疗中的免疫治疗

英文原题:Ph- ALL: immunotherapy in upfront treatment.

查看英文原题

Ph- ALL: immunotherapy in upfront treatment.

PubMed 2024/12/06(内容时间) Hematology Am Soc Hematol Educ Program Q1 · IF 3.7(JCR 2025)

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研究概要

基于抗体的和基于细胞的新型免疫疗法,如双特异性 T 细胞衔接器(BiTE)、抗体药物偶联物或嵌合抗原受体(CAR)T 细胞,目前是复发/难治性(R/R)B 细胞前体急性淋巴细胞白血病(ALL)患者的标准治疗选择。

中文摘要

双特异性T细胞衔接器(BiTE)、抗体药物偶联物和嵌合抗原受体(CAR)T细胞等新型抗体及细胞免疫疗法,目前已成为复发/难治性(R/R)B细胞前体急性淋巴细胞白血病(ALL)的标准治疗选择。迄今,靶向CD20的单克隆抗体及靶向CD19的BiTE blinatumomab已成为一线治疗的成熟组成部分,分别用于CD20阳性ALL患者,或传统化疗后仍存在可测量疾病(MRD)的患者。近期研究还显示,blinatumomab可使MRD阴性ALL患者获得生存获益。鉴于R/R ALL患者中观察到较高缓解率和更佳生存结局,研究者正在前瞻性评估将抗体免疫疗法用于初始治疗,尤其是老年成人患者;此类患者即使接受年龄适配的传统化疗,仍有较高早期死亡率、治疗相关毒性及不良预后。在这些治疗策略中,传统化疗被免疫治疗药物替代或减量后联合免疫治疗,取得了良好结局,成为评估并确立新治疗标准的依据。

展开英文摘要原文

Antibody-based and cell-based novel immunotherapies, such as bispecific T-cell engagers (BiTE), antibody-drug conjugates, or chimeric antigen receptor (CAR) T cells are currently standard treatment options for patients with relapsed or refractory (R/R) B-cell precursor acute lymphoblastic leukemia (ALL). To date, CD20-targeting monoclonal antibodies and the CD19-targeting BiTE's blinatumomab have been established elements of frontline therapy, either in patients with CD20+ ALL or in patients with measurable disease (MRD) following conventional chemotherapy. Recently, blinatumomab has also demonstrated a survival benefit in patients with MRD-negative ALL. Based on the observed high response rates and improved survival outcomes in patients with R/R ALL, antibody-based immunotherapies are being prospectively studied in the upfront setting, particularly in older adult patients, where even age-adapted conventional chemotherapies are still associated with significant rates of early death, treatment-related toxicity, and poor prognosis. In these approaches, conventional chemotherapy has been replaced or reduced and supplemented by immunotherapeutic agents, resulting in promising outcomes that form the basis for evaluating and defining new treatment standards.

论文信息

作者
Stelljes M
单位
Department of Medicine A, Hematology and Oncology, University Hospital Münster, Münster, Germany.Germany
文献类型
综述
期刊
Hematology. American Society of Hematology. Education Program2024 Dec 6
原文标识
PubMed 39644077 · DOI 10.1182/hematology.2024000531