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.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Epidemiology and approaches for management of relapsed and refractory multiple myeloma in Gulf Countries: a narrative review and insights from the Gulf multiple myeloma experts.
Epidemiology and approaches for management of relapsed and refractory multiple myeloma in Gulf Countries: a narrative review and insights from the Gulf multiple myeloma experts.
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多发性骨髓瘤(MM)是一种血液系统恶性肿瘤,以浆细胞克隆性增殖为特征,可导致显著发病和死亡。尽管治疗进步改善了临床结局,但获益主要局限于部分高收入国家。海湾地区国家虽然国内生产总值(GDP)大幅增长,但资源有限;这些国家医疗卫生支出占GDP比例较低,因此MM管理面临独特挑战。本叙述性分析探讨阿联酋、卡塔尔、巴林、科威特和阿曼等海湾国家复发/难治性多发性骨髓瘤(RRMM)的流行病学、患者人口学特征及治疗现状。
我们的发现强调,MM在该地区发病率不断上升;诊断延迟、部分地区先进药物可及性有限及医疗服务差异导致死亡率升高。海湾国家患者确诊年龄通常较全球其他地区患者更年轻,诊断年龄中位数为43至58岁。CAR-T 细胞疗法和双特异性抗体等创新疗法因费用高和基础设施障碍而难以普及。多数国家虽可开展干细胞移植,但利用不足,治疗仍常依赖传统药物。诊断不及时、难以到达治疗中心、创新疗法供应不足及区域监测方案不充分,妨碍了疾病的有效管理。海湾MM顾问委员会的意见强调,需要制定个体化治疗方案、提高新疗法可及性并改善医疗基础设施。医疗专业人员、决策者和产业利益相关方开展合作,对于制定区域治疗方案和加强临床试验网络至关重要。正视这些不足,对改善患者结局并使海湾地区MM治疗与国际标准接轨十分关键。通俗摘要:多发性骨髓瘤(MM)是由浆细胞失控生长导致的血癌,会引发严重健康问题。
尽管一些发达国家的治疗已有改善,海湾国家仍因医疗卫生支出有限而面临挑战。本分析考察阿联酋、卡塔尔、巴林、科威特和阿曼的MM情况。MM在全球通常影响老年人,但海湾地区患者确诊年龄较小,为43至58岁。该地区MM发病率不断上升,诊断延迟、先进药物可及性有限和医疗服务不平等导致死亡率更高。CAR-T 细胞疗法和双特异性抗体等创新疗法费用高且难以获得。虽然可以进行干细胞移植,但利用不足,治疗常依赖传统药物。该地区MM管理面临的挑战包括诊断延迟、先进疗法可及性有限和治疗实践不一致;高成本和物流问题限制了新型免疫疗法的应用,缺乏标准化监测和医疗服务差异也进一步妨碍结局改善。海湾MM顾问委员会强调,需要个体化治疗方案、更好地获得新疗法并改善医疗基础设施。协作是制定区域治疗方案和加强临床试验网络的关键,将有助改善患者结局并使海湾地区MM治疗达到国际标准。
Multiple myeloma (MM) is a hematologic malignancy characterized by the clonal proliferation of plasma cells, resulting in considerable morbidity and mortality. Although therapeutic advancements have improved clinical outcomes, this has been restricted to some high-income nations.
Countries in the Gulf region, despite significant rises in gross domestic product (GDP), have resource-constrained environments and hence face unique challenges when it comes to the management of MM mainly because of the limited spending on healthcare (as a percentage of the GDP) in these countries. This narrative analysis explores the epidemiology, patient demographics, and therapeutic landscape of relapsed and refractory multiple myeloma (RRMM) in Gulf nations, including the United Arab Emirates (UAE), Qatar, Bahrain, Kuwait, and Oman.
Our findings emphasize the growing incidence of MM in the region, with increased mortality rates owing to delayed diagnosis, restricted access to some of the advanced medicines in few areas, and disparities in care. Patients in the Gulf countries usually present at a younger age than their global counterparts, with median ages of diagnosis ranging from 43 to 58 years. Access to innovative treatments like CAR T-cell therapy and bispecific antibodies has been limited by high costs and infrastructural barriers. Stem-cell transplantation, although available in most countries, is insufficiently utilized, and treatment approaches frequently depend on conventional medicines. Obstacles to prompt diagnosis, difficulty in accessing treatment centers, limited availability of innovative treatment, and inadequate regional monitoring protocols, impede efficient illness management. Insights from the Gulf MM Advisory Board highlight the need for individualized treatment protocols, enhanced accessibility to novel treatments, and improvements in healthcare infrastructure. Cooperative initiatives among healthcare professionals, decision makers, and industry stakeholders are crucial for formulating regional treatment protocols and enhancing clinical trial networks. Reflecting on these shortcomings will be critical to improving patient outcomes and aligning MM care in the Gulf region with international standards.
Multiple myeloma (MM) is a blood cancer caused by the uncontrolled growth of plasma cells, leading to serious health issues. While treatment has improved in some developed countries, Gulf nations face challenges due to limited healthcare spending. This analysis looks at MM in the Gulf countries: UAE, Qatar, Bahrain, Kuwait, and Oman. MM usually affects older people globally, but in the Gulf, patients are diagnosed younger, between 43 and 58 years old. The incidence of MM is rising in the region, with higher death rates due to late diagnosis, limited access to advanced medicines, and unequal care. Innovative treatments like CAR T-cell therapy and bispecific antibodies are expensive and hard to access.
Stem-cell transplants are available but underused, and conventional medicines are often relied upon. Challenges in MM management in the Gulf include late diagnosis, limited access to advanced therapies, and inconsistent treatment practices. High costs and logistical issues restrict the use of new immunotherapies. Lack of standardized monitoring and healthcare disparities further hinder outcomes.
The Gulf MM Advisory Board highlights the need for personalized treatment protocols, better access to new treatments, and improved healthcare infrastructure. Collaborative efforts are key to developing regional treatment protocols and strengthening clinical trial networks, which will enhance patient outcomes and align MM care in the Gulf with international standards.
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