决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:The 2024 EBMT activity report: crossing one million HCTs and 20,000 CAR-T. A landmark in cellular therapy.
该年,53 个国家的 688 个中心在 43,791 例患者中共报告了 47,204 例 HCT(21,023 例异基因,26,181 例自体)。
2024年,EBMT活动调查累计报告的造血细胞移植(HCT)自1990年以来超过100万例,这是细胞治疗领域的重要里程碑。该年,来自53个国家688家中心的43,791名患者共报告47,204例HCT(异基因21,023例,自体26,181例)。与2023年相比,HCT总量下降(总体-1.1%,自体移植-3.9%),而异基因移植增加2.6%,达到迄今最高年度数量。CAR-T疗法覆盖6,082名患者(较2023年增加24.5%),自2018年以来累计超过20,000例。异基因HCT主要适应证为髓系疾病(62%)、淋巴系恶性肿瘤(约24%)和非恶性疾病(约17%)。自体HCT主要适应证为浆细胞疾病(59%)、淋巴瘤(22%)和实体瘤(约6%)。无关供者移植比例上升5%至56%,HLA相合同胞(25%)和单倍体相合供者(19%)比例保持稳定。脐带血使用量继续下降(-6.2%)。儿科HCT数量略有下降(-1.7%;异基因-1.9%,自体-1.1%)。CAR-T治疗规模扩大,淋巴瘤仍为首要适应证(70%),其次为多发性骨髓瘤(18%)和ALL(8%);自身免疫性疾病适应证增加67%。总体而言,移植和CAR-T治疗活动稳步增加,安全措施缓解了疫情相关下降,体现出体系韧性,同时各国贡献有所差异。从2025年起,EBMT调查将分别统计成人和儿童治疗活动,建立综合数据库以监测趋势、指导实践、界定临床需求并评估公平可及性。
In 2024, the EBMT activity survey surpassed one million HCTs reported since 1990, a major milestone in cellular therapy. That year, 47,204 HCTs (21,023 allogeneic, 26,181 autologous) were reported in 43,791 patients across 688 centres in 53 countries. Compared to 2023, HCT activity decreased (-1.1% overall, -3.9% autologous), while allogeneic increased ( + 2.6%) to the highest annual activity to date. CAR-T therapy reached 6,082 patients ( + 24.5% vs 2023), surpassing 20,000 since 2018. Main indications for allo-HCT were myeloid (62%), lymphoid malignancies (~24%), and non-malignant disorders (~17%). For auto-HCT were plasma cell disorders (59%), lymphomas (22%), and solid tumours (~6%). Unrelated donors (56%) increased ( + 5%), while HLA-identical siblings (25%) and haploidentical (19%) remained stable. Cord blood use continued decreasing (-6.2%). Paediatric HCT activity decreased slightly (-1.7%; -1.9% allogeneic, -1.1% autologous). CAR-T therapy expanded (lymphomas remaining the leading indication (70%), followed by multiple myeloma (18%,) and ALL (8%). Autoimmune diseases indications increased by 67%). Overall, transplant and CAR-T activity steadily increased, with pandemic-related declines mitigated by safety measures, reflecting systems resilience and variable country contributions. From 2025, the EBMT survey will capture adult and paediatric activity separately, establishing a comprehensive database to monitor trends, inform practice, define clinical needs and assess equitable access.
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