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复发性/难治性 AL 淀粉样变性的管理

英文原题:Management of relapsed/refractory AL amyloidosis.

查看英文原题

Management of relapsed/refractory AL amyloidosis.

PubMed 2026/06/09(内容时间) Blood Adv Q1 · IF 7.7(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

中文摘要

系统性淀粉样轻链(AL)淀粉样变性的前线治疗已随着达雷妥尤单抗联合硼替佐米、环磷酰胺和地塞米松的获批而发生显著演变,该方案显著提高了血液学和器官缓解率。尽管取得了这些进展,许多患者最终仍会复发,目前尚无既定的标准挽救方案或最佳时机。在这篇综述中,我们探讨了挽救方案的最佳时机以及达雷妥尤单抗治疗失败后当前可用的治疗选择,包括下一代蛋白酶体抑制剂或免疫调节药物、自体干细胞移植、BCL-2抑制剂,以及新兴的免疫治疗药物,如CAR-T 细胞疗法和双特异性抗体。

展开英文摘要原文

Frontline therapy for systemic amyloid light chain (AL) amyloidosis has evolved significantly with the approval of daratumumab in combination with bortezomib, cyclophosphamide, and dexamethasone, which has significantly improved rates of both hematologic and organ responses. Despite these advances, many patients eventually relapse, and there remains no established standard salvage regimen or optimal timing.

In this review, we examine optimal timing of salvage regimens and currently available therapeutic options after daratumumab failure, including next-generation proteosome inhibitors or immunomodulatory drugs, autologous stem cell transplant, BCL-2 inhibitors, and emerging immunotherapeutic agents such as chimeric antigen receptor T-cell therapy and bispecific antibodies.

论文信息

作者
Ling J、Sidiqi MH、Gertz M
第一作者单位
Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia.Australia
通讯作者单位
Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.United States
文献类型
综述
期刊
Blood advances2026 Jun 9
原文标识
PubMed 41894688 · DOI 10.1182/bloodadvances.2025019223