不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Evaluating the safety and feasibility of allogeneic NK cell infusion in high-risk lymphoma patients post-autologous stem cell transplantation.
Evaluating the safety and feasibility of allogeneic NK cell infusion in high-risk lymphoma patients post-autologous stem cell transplantation.
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淋巴瘤是一类预后较差的癌症,已成为日益严峻的全球健康挑战,包括霍奇金淋巴瘤(HL)和非霍奇金淋巴瘤(NHL)两大类型,各自又分为具有不同生物学行为的多种亚型。传统治疗包括化疗、放疗、手术和自体造血干细胞移植(auto-HSCT)。自然杀伤(NK)细胞具有内在的肿瘤细胞毒性,无需预先免疫或活化。在这项前瞻性临床试验中,我们评估了异基因NK细胞疗法用于预后不良的高危淋巴瘤患者的可行性。每例患者输注1×10⁷个NK细胞/kg,不补充白细胞介素-2(IL-2)。治疗耐受性良好,未发生移植物抗宿主病、细胞因子释放综合征或神经毒性。随访期间,7例达到完全缓解(CR,87.5%),1例病情稳定(SD,12.5%)。
总之,我们的研究支持开发异基因NK细胞疗法,用于晚期淋巴瘤并克服化疗耐药。通过破坏免疫抑制环境及输注外源性IL-15,或可进一步提高疗效。这一方法为HSCT后高危淋巴瘤管理提供了一种有前景且务实的策略。未来研究应重点优化NK细胞剂量和输注频率,以最大化治疗效果。
Lymphoma, a cancer with poor prognosis is a growing global health challenge that encompasses two primary types, Hodgkin (HL) and non-Hodgkin lymphoma (NHL), each further divided into various subtypes with distinct biological behaviors. Conventional therapeutic strategies include chemotherapy, radiation, surgery, and autologous hematopoietic stem cell transplantation (auto-HSCT). Natural killer (NK) cells exhibit intrinsic cytotoxicity against tumor cells without the need for prior immunization or activation. In this prospective clinical trial, we evaluated the feasibility of allogeneic NK cell therapy in patients with high-risk lymphoma who had a poor prognosis. Each patient received 1 107 NK cells/kg infusion without interleukin-2 (IL-2) supplementation.
Therapy was tolerated without graft-versus-host-disease, cytokine release syndrome, or neurotoxicity. During the follow-up period, 7 had complete responses (CR) (87. 5%) and one case exhibited stable disease (SD) (12. 5%). In summary, our investigations support the development of allogeneic NK cellular therapies for advanced lymphoma to overcome chemoresistance.
Therapeutic efficacy may be further improved by disrupting the immunosuppressive environment and infusion of exogenous IL-15. This approach presents a promising and pragmatic strategy for managing high-risk lymphoma post-HSCT. Future research should focus on optimizing NK cell dosages and infusion frequency to maximize treatment effectiveness.
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