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:Epstein-Barr Virus-Associated T/NK-Cell Neoplasms.
Epstein-Barr Virus-Associated T/NK-Cell Neoplasms.
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EBV相关T细胞和自然杀伤(NK)细胞肿瘤涵盖了一个异质性谱系,从持续性淋巴增殖性疾病(如严重蚊叮咬过敏、系统性慢性活动性EBV病)到高度侵袭性恶性肿瘤(如结外NK/T细胞淋巴瘤[ENKTL]、侵袭性NK细胞白血病)。基因组学和表观遗传学研究揭示了共同的宿主遗传学改变——最显著的是JAK-STAT信号通路、表观遗传调控因子、TP53和DDX3X——支持这些疾病之间存在致病性和临床生物学连续性。缺陷型EBV进一步重塑病毒基因表达程序并促进肿瘤发生。以l-天冬酰胺酶为基础的放化疗改善了早期ENKTL的结局;然而,晚期疾病和其他EBV相关T/NK细胞肿瘤的有效治疗仍然有限。新兴的分子亚分类和大规模前瞻性队列有助于阐明疾病异质性并加速精准治疗策略的开发。
Epstein-Barr virus (EBV)-associated T- and natural killer (NK)-cell neoplasms encompass a heterogeneous spectrum, ranging from persistent lymphoproliferative disorders (e. g. , severe mosquito bite allergy, systemic chronic active EBV disease) to highly aggressive malignancies (e. g. , extranodal NK/T-cell lymphoma [ENKTL], aggressive NK-cell leukemia). Genomic and epigenetic studies have revealed shared host genetic alterations-most notably in JAK-STAT signaling, epigenetic regulators, TP53, and DDX3X-supporting a pathogenic and clinicobiological continuum across these disorders.
Defective EBV further reshapes viral gene expression programs and contributes to oncogenesis. l-asparaginase-based chemoradiotherapy has improved outcomes in early-stage ENKTL; however, effective treatments for advanced-stage disease and other EBV-associated T/NK-cell neoplasms remain limited. Emerging molecular subclassifications and large-scale prospective cohorts can help clarify disease heterogeneity and accelerate the development of precision therapeutic strategies.
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