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定义血液系统恶性肿瘤的治疗线数:EBMT 实践协调与指南委员会提出的系统而全面的框架

英文原题:Defining lines of therapy in haematological malignancies: a proposed systematic and comprehensive framework from the EBMT Practice Harmonisation and Guidelines Committee.

PubMed 2026/06/03(内容时间) Bone Marrow Transplant Q1 · IF 5.1(JCR 2025)

研究概要

血液系统恶性肿瘤的治疗格局已被靶向治疗、免疫治疗和细胞治疗所改变,导致更复杂和更长的临床病程。

中文摘要

靶向治疗、免疫治疗和细胞治疗改变了血液系统恶性肿瘤的治疗格局,使临床病程更加复杂且持续时间更长。目前,“治疗线数”(LoT)的定义和记录方式存在显著差异,阻碍了研究和数据标准化。为此,EBMT实践协调与指南委员会制定了适用于急性白血病、淋巴瘤和多发性骨髓瘤的LoT标准框架。LoT定义为旨在实现或维持疾病控制的连贯治疗阶段,可包含一个或多个全身治疗阶段,如诱导、巩固或维持治疗;这些治疗应在未发生疾病进展、治疗失败或重大毒性的情况下实施。经记录确认疾病进展、复发或原发难治时,计为新治疗线;为加深应答而引入不同治疗类别的药物也构成新治疗线,而为管理毒性进行剂量调整、方案改变或计划性省略则不构成新治疗线。细胞治疗(包括CAR-T或移植)前实施的桥接治疗,视为与最终治疗属于同一治疗线。该倡议旨在加强方法学严谨性、提高治疗报告清晰度,并支持精准血液学中的循证决策。

展开英文摘要原文

The therapeutic landscape of hematological malignancies has been transformed by targeted therapies, immunotherapy, and cellular therapies, leading to more complex and prolonged clinical courses. Currently, there is substantial variability in how "lines of therapy" (LoT) are defined and recorded, which hinders research and data harmonization. To address this, the EBMT Practice Harmonisation and Guidelines Committee has developed a standardized framework for LoT across acute leukemias, lymphomas, and multiple myeloma. A LoT is defined as a coherent therapeutic episode aimed at achieving or maintaining disease control, comprising one or more systemic treatment phases such as induction, consolidation, or maintenance, administered in the absence of disease progression, treatment failure, or major toxicity. A new LoT is assigned at documented progression, relapse, or primary refractory disease, and the introduction of an agent from a distinct therapeutic class to deepen response also constitutes a new line, whereas dose adjustments, schedule changes, or planned omissions to manage toxicity do not create a new LoT. Bridging therapies administered prior to cellular therapy, including CAR-T or transplantation, are considered part of the same LoT as the definitive treatment. This initiative aims to enhance methodological rigor, improve clarity in treatment reporting, and support evidence-based decision-making in precision hematology.

论文信息

作者
Criscimanna A、Galimard JE、Sánchez-Ortega I、Hayden PJ、Garderet L、Sureda A、Ciceri F、McLornan DP
第一作者单位
Hematology and BMT Unit, IRCCS San Raffaele Hospital, Milano, Italy.Italy
通讯作者单位
Hematology and BMT Unit, IRCCS San Raffaele Hospital, Milano, Italy. annalisaruggeri80@hotmail.com.Italy
文献类型
综述
期刊
Bone marrow transplantation2026 Aug
原文标识
PubMed 42237010 · DOI 10.1038/s41409-026-02914-0