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异基因造血干细胞移植后儿童白血病患者的过继性细胞疗法

英文原题:Adoptive Cellular Therapies in Pediatric Leukemia Patients After Allogeneic-Hematopoietic Stem Cell Transplants.

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Adoptive Cellular Therapies in Pediatric Leukemia Patients After Allogeneic-Hematopoietic Stem Cell Transplants.

PubMed 2025/08/12(内容时间) Immune Netw Q1 · IF 5.9(JCR 2025)

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中文摘要

异基因造血干细胞移植(allo-HSCT)可为接受一线治疗后的高危白血病患者带来治愈机会,其疗效依赖强大的免疫细胞介导抗肿瘤作用。尽管能够实现深度缓解,许多患者仍会在allo-HSCT后复发,后续治疗选择有限。鉴于allo-HSCT具有强效免疫细胞介导的抗白血病作用,研究者已探索将过继细胞疗法(ACT)作为辅助治疗,以增强allo-HSCT疗效,或治疗allo-HSCT后复发患者。有证据表明,由于遗传突变和治疗耐受性存在差异,儿童和成人白血病病例可能需要不同的分层治疗策略。

然而,儿童特异性研究有限,尤其是关于allo-HSCT后复发的细胞治疗研究。ACT已知的严重毒性需要针对这一年轻人群加以管理,以保障长期生活质量。本综述总结allo-HSCT后治疗儿童白血病的ACT现状,包括供者淋巴细胞输注、嵌合抗原受体(CAR)T细胞、NK细胞和双阴性T细胞疗法,并重点介绍疗效、安全性及儿童特异性数据缺口,为未来研究提供指导。

展开英文摘要原文

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) provides a curative potential for high-risk patients with leukemia following first-line therapies, driven by potent immune cell-dependent anti-tumour activities. Although deep remission can be achieved, many patients relapse after allo-HSCT, and further treatment options are scarce.

Given the potent immune cell-mediated anti-leukemic effects of allo-HSCT, adoptive cellular therapies (ACTs) have been explored as an adjunctive therapy to enhance the efficacy of allo-HSCT or to treat patients who relapse after allo-HSCT. Interestingly, evidence suggests a stratified therapeutic approach is warranted between pediatric and adult leukemic cases, due to differences in genetic mutations and treatment tolerability.

However, pediatric-specific investigations are limited, especially in the cellular therapeutic landscape to treat relapse after allo-HSCT. Known severe toxicities attributed to ACTs need to be addressed for this younger population to ensure prolonged quality of life.

This review summarizes the current landscape of ACTs, including donor lymphocyte infusion, chimeric Ag receptor-T cell, NK cell, and double-negative T cell therapies, for treating pediatric leukemia post allo-HSCT, highlighting efficacy, safety, and gaps in pediatric-specific data to guide future research.

论文信息

作者
Palichuk L、Tin E、Lee J
第一作者单位
Department of Medical Science, Cumming School of Medicine, University of Calgary, Calgary T2N 1N4, Canada.Canada
通讯作者单位
Riddell Centre for Cancer Immunotherapy, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary T2N 1N4, Canada.Canada
文献类型
综述
期刊
Immune network2025 Aug
原文标识
PubMed 40917789 · DOI 10.4110/in.2025.25.e29