肿瘤细胞治疗研究
英文原题:A review of treatment strategies for elderly patients with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia.
A review of treatment strategies for elderly patients with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia.
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费城染色体阴性B细胞急性淋巴细胞白血病(Ph− B-ALL)老年患者的治疗仍具挑战,原因包括不良遗传特征发生率高、合并症常见及治疗相关毒性显著;这些因素共同限制传统化疗疗效,导致长期生存不佳。近年新型靶向药物和免疫疗法不断出现,显著改善了这一人群的治疗前景。本综述总结老年Ph− B-ALL患者应用低强度化疗、CD19/CD22靶向抗体(如贝林妥欧单抗和奥加伊妥珠单抗)、BCL-2抑制剂维奈克拉及嵌合抗原受体(CAR)T细胞疗法的近期进展。临床研究显示,这些策略可提高缓解率和生存,同时降低治疗相关毒性,对不适合强化化疗的老年患者尤其有益。未来应重点优化联合和序贯方案,并个体化治疗,以进一步改善疗效和安全性。
The treatment of elderly patients with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia (pH B-ALL) remains challenging because of the high frequency of adverse genetic features, common comorbidities, and significant treatment-related toxicities, which collectively limit the efficacy of conventional chemotherapy and result in poor long-term survival. Recent years have witnessed the emergence of novel targeted agents and immunotherapies, substantially improving the therapeutic outlook for this population.
This review summarizes recent advances in the application of low-intensity chemotherapy, CD19/CD22-targeting antibodies such as blinatumomab and inotuzumab ozogamicin, the BCL-2 inhibitor venetoclax, and chimeric antigen receptor (CAR) T-cell therapy for elderly pH B-ALL patients.
Clinical studies indicate that these strategies can increase remission rates and survival while reducing treatment-related toxicity, offering particular benefit to older patients who are unsuitable for intensive chemotherapy. Future efforts should focus on optimizing combination and sequential regimens, as well as personalizing treatment approaches to further improve efficacy and safety.
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