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CAR-T 细胞疗法治疗儿童急性淋巴细胞白血病:疗效、安全性与未来方向

英文原题:Chimeric Antigen Receptor T-cell Therapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia: Efficacy, Safety, and Future Directions.

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Chimeric Antigen Receptor T-cell Therapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia: Efficacy, Safety, and Future Directions.

PubMed 2025/07/31(内容时间) Cureus

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中文摘要

儿童急性淋巴细胞白血病(ALL)的治疗面临重大挑战,复发/难治性病例尤其如此。本综述整合了近期关于CAR-T(CAR-T)细胞疗法安全性和疗效的研究,重点关注tisagenlecleucel在儿童ALL患者中实现完全缓解(CR)并改善总生存率的情况。通过全面文献检索,纳入2014年1月至2024年7月发表的12项研究,包括队列研究和临床试验。结果显示,CAR-T 细胞疗法的CR率较高(部分研究中可达100%),安全性可管理,常见不良反应包括细胞因子释放综合征(CRS)和神经毒性。本综述指出若干重要方面:鉴定用于预测应答的生物标志物、理解耐药机制,以及迫切需要长期结局数据。如何管理不良反应,尤其是CRS和神经毒性,仍是挑战。本综述强调CAR-T 细胞疗法在儿科肿瘤治疗中的变革性潜力,同时指出仍需进一步研究的关键领域,以优化患者结局并拓展儿童ALL治疗前景。

展开英文摘要原文

Pediatric acute lymphoblastic leukemia (ALL) poses significant treatment challenges, particularly in relapsed or refractory cases. This review synthesizes recent studies evaluating the safety and efficacy of chimeric antigen receptor T (CAR-T) cell therapy, specifically tisagenlecleucel, in achieving complete remission (CR) and improving overall survival rates among pediatric patients with ALL. A comprehensive literature search identified 12 studies published between January 2014 and July 2024, encompassing cohort studies and clinical trials. Findings indicate that CAR-T cell therapy demonstrates superior CR rates (up to 100% in some studies) and manageable safety profiles, with common adverse effects, including cytokine release syndrome (CRS) and neurotoxicity.

This review points out some of the important aspects such as the identification of biomarkers for response prediction, understanding of the mechanisms of resistance, and the crucial requirement for long-term outcome data. Challenges remain in the management of adverse effects, particularly CRS and neurotoxicity. This review underscores the transformative potential of CAR-T cell therapy in pediatric oncology while emphasizing critical areas for further investigation to optimize patient outcomes and enhance the therapeutic landscape for pediatric ALL.

论文信息

作者
Shamim H、Jhakri K、Al-Shudifat M、Sumra B、Kocherry C、Malasevskaia I
第一作者单位
Pediatrics, Baqai Medical University, Karachi, PAK.
通讯作者单位
Obstetrics and Gynecology, Private Clinic 'Yana Alexandr', Sana'a, YEM.
文献类型
综述
期刊
Cureus2025 Jul
原文标识
PubMed 40895845 · DOI 10.7759/cureus.89172