CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Clinical Outcomes of CD7 CAR-T Cell Therapy in Relapsed or Refractory T-Cell Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma Patients.
Clinical Outcomes of CD7 CAR-T Cell Therapy in Relapsed or Refractory T-Cell Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma Patients.
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复发/难治性T细胞急性淋巴细胞白血病及淋巴母细胞淋巴瘤(R/R T-ALL/LBL)患者预后不佳。早期临床试验中,嵌合抗原受体(CAR)T细胞治疗T-ALL/LBL已显示令人鼓舞的结果。本文回顾性分析12例接受CD7 CAR-T 细胞治疗的R/R T-ALL/LBL患者结局。其中11例接受自体CAR-T 细胞,1例接受异体CAR-T 细胞。输注后第28天,67%(8/12)患者达到客观应答。中位随访134天(范围14–925天)时,中位总生存期(OS)为134天,无进展生存期(PFS)为81天。8例输注CD7 CAR-T 后缓解的患者中,5例接受异基因造血干细胞移植(allo-HSCT)巩固治疗。与未接受巩固allo-HSCT的3例患者相比,接受巩固移植者OS呈改善趋势(移植组与对照组6个月OS为60%比33.3%,P=.073),PFS更佳(6个月PFS为60%比0%,P=.022)。所有患者均发生细胞因子释放综合征(CRS;67%为1–2级,33%为3级),1例出现神经毒性。CD7 CAR-T 细胞疗法是R/R T-ALL/LBL一种有前景且不良反应可管理的治疗选择;输注CD7 CAR-T 后再行巩固allo-HSCT可能有助于延长缓解持续时间。
Relapse and refractory T-cell acute lymphoblastic leukemia and lymphoblastic lymphoma (R/R T-ALL/LBL) patients have poor outcomes. Chimeric antigen receptor (CAR)-T-cell therapy for T-ALL/LBL has shown encouraging results in the early stages of clinical trials.
Here, we retrospectively analyzed the outcomes of 12 patients with R/R T-ALL/LBL who received CD7 CAR-T cell therapy. Eleven patients received autologous CAR-T cells, while one patient received allogeneic CAR-T cells. On Day 28 post-infusion, 67% (8/12) of patients achieved an overall response (ORR). At a median follow-up of 134 (14-925) days, the median overall survival (OS) was 134 days, and the progression-free survival (PFS) was 81 days. Among the 8 patients who achieved remission after CD7 CAR-T cell infusion, 5 patients received consolidation allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Compared with 3 patients who did not undergo consolidation allo-HSCT, patients with allo-HSCT as consolidation showed a trend toward better OS (allo-HSCT vs. control: 6-month OS, 60% vs. 33. 3%, p = 0. 073) and better PFS (allo-HSCT vs. control: 6-month PFS, 60% vs. 0%, p = 0. 022). Cytokine release syndrome (CRS) occurred in all patients (grade 1-2 in 67% of patients, grade 3 in 33% of patients), and one patient experienced neurotoxicity. CD7 CAR-T cell therapy is a promising option for R/R T-ALL/LBL patients with manageable adverse events.
Moreover, CD7 CAR-T cell infusion followed by consolidation allo-HSCT in R/R T-ALL/LBL patients might play an important role in prolonging remission duration.
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