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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Outcomes of point-of-care manufactured CAR T cell therapy for B cell acute lymphoblastic leukemia and non-Hodgkin lymphoma in Vietnam.
Outcomes of point-of-care manufactured CAR T cell therapy for B cell acute lymphoblastic leukemia and non-Hodgkin lymphoma in Vietnam.
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嵌合抗原受体(CAR)T细胞疗法已改变了复发/难治性(R/R)B细胞急性淋巴细胞白血病(ALL)和非霍奇金淋巴瘤(NHL)的治疗,但在资源受限地区其可及性仍然有限。这项I期研究评估了在越南患者中即时(PoC)生产的CD19靶向CAR-T 细胞疗法的安全性和可行性。2023年8月至2025年6月期间,共入组16例患者,其中8例为R/R ALL,8例为R/R NHL。所有患者均接受了使用CliniMACS Prodigy系统在本地生产的新鲜CAR-T 细胞,中位剂量为1.9 10 6 CAR-T 细胞/kg(范围,0.83-2.17 10 6)。
13例患者发生细胞因子释放综合征(CRS)(12例为1-2级,1例为3级),2例患者观察到1级神经毒性。在ALL中,第30天的完全缓解(CR)率为100%,第90天为75%,第180天为62.5%。NHL患者在第90天和第180天的CR率均为87.5%。估计1年无进展生存率在ALL中为62.5%(95%置信区间[CI]:36.5%-100%),在NHL中为87.5%(95% CI:67.3%-100%)。PoC生产的CD19 CAR-T 细胞在越南R/R ALL和NHL患者中显示出可控的毒性和令人鼓舞的早期疗效。该模式为在资源受限地区提供先进治疗提供了一种具有成本效益的策略。
Chimeric antigen receptor (CAR) T cell therapy has transformed the treatment of relapsed/refractory (R/R) B cell acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL), but access remains limited in resource-constrained settings. This phase I study evaluated the safety and feasibility of point-of-care (PoC) manufactured CD19-targeted CAR T cell therapy in Vietnamese patients. Between August 2023 and June 2025, 16 patients, eight with R/R ALL and eight with R/R NHL, were enrolled. All received fresh CAR T cells produced on-site using the CliniMACS Prodigy system, with a median dose of 1. 9 10 6 CAR T cells/kg (range, 0. 83-2. 17 10 6 ).
Cytokine release syndrome (CRS) occurred in 13 patients (12 with grade 1-2, one with grade 3), and grade 1 neurotoxicity was observed in two patients. In ALL, the complete remission (CR) rates were 100% on day 30, 75% on day 90, and 62. 5% on day 180. Patients with NHL showed CR rates of 87. 5% on both day 90 and day 180. The estimated 1-year progression-free survival rates were 62.
5% (95% confidence interval [CI]: 36. 5%-100%) for ALL and 87. 5% (95% CI: 67. 3%-100%) for NHL. PoC manufactured CD19 CAR T cells demonstrated manageable toxicity and encouraging early efficacy in Vietnamese patients with R/R ALL and NHL. This model offers a cost-effective strategy for delivering advanced therapy in resource-limited settings.
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