肿瘤细胞治疗研究
英文原题：Prognostic factors in chronic lymphocytic leukaemia - the old, the new and the future.
慢性淋巴细胞白血病（CLL）的预后评估对于及时提供个体化治疗至关重要。
慢性淋巴细胞白血病（CLL）的预后评估对于及时提供个体化治疗至关重要。在化学免疫治疗（CIT）时代，TP53状态、核型、IGHV突变状态、微小残留病（MRD）、基因突变和细胞增殖标志物是重要的预后工具。使用BCL2抑制剂（BCL2i）时，结局仍受IGHV状态、TP53状态、复杂核型以及是否达到不可检测的MRD影响。另一方面，BTK抑制剂（BTKi）与IGHV状态无关，很少导致MRD阴性缓解，且受TP53状态的影响较不明确。尽管基于较不成熟的数据，BCL2i/BTKi联合治疗的结局可能受TP53和IGHV状态影响。对非共价BTKI（ncBTKI）的应答受既往共价BTKi耐药机制的影响。最后，对CAR-T 细胞疗法（CAR-T）的应答似乎与TP53状态无关，但取决于整体T细胞适应性。
Prognostic assessment in chronic lymphocytic leukemia (CLL) is essential for delivery of timely, personalized therapy. TP53 status, karyotype, IGHV mutational status, minimal residual disease (MRD), gene mutations and markers of cell proliferation were important prognostic tools in the era of chemo-immunotherapy (CIT). With BCL2 inhibitors (BCL2i), outcome is still impacted by IGHV status, TP53 status, complex karyotype, and achievement of undetectable MRD. On the other hand, BTK inhibitors (BTKi) are agnostic to IGHV status, rarely cause MRD negative remissions and are less clearly impacted by TP53 status. Although based on less mature data, outcomes with BCL2i/BTKi combinations are likely influenced by TP53 and IGHV status. Responses to non-covalent BTKI (ncBTKI) are impacted by the mechanism of resistance to previous covalent BTKi. Finally, responses to chimeric antigen receptor T cell therapy (CAR-T) appear independent of TP53 status, but dependent on overall T- cell fitness.
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