← 返回前沿论文

中低收入国家学术型与床旁 CAR-T 细胞治疗的当前格局

英文原题:Current landscape of academic and point of care CAR-T cell therapy in low-middle income countries.

查看英文原题

Current landscape of academic and point of care CAR-T cell therapy in low-middle income countries.

PubMed 2026/06/29(内容时间) Clin Hematol Int

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

CAR-T 细胞疗法已成为复发/难治性血液系统恶性肿瘤患者的一种变革性治疗,为传统移植之外提供了新的可能。CAR-T 产品在高收入国家获批后显示出显著疗效;然而,由于基础设施不足、监管要求复杂及成本高昂,其在中低收入国家(LMIC)的应用仍有限。在墨西哥等部分国家,这些障碍尤为突出,包括临床级载体可及性有限、早期临床研究项目不足,以及缺乏政府和私营部门基础设施与资金支持。尽管如此,当地有大量B细胞急性淋巴细胞白血病、多发性骨髓瘤或弥漫性大B细胞淋巴瘤患者可能从CAR-T 治疗中获益。学术机构开展的床旁制造进展,尤其是使用封闭式半自动系统,已证明其在LMIC中的可行性:既可降低成本、简化流程,又能保持产品质量。这些方法可能成为商业化产品的可行替代方案,有望减轻经济负担并提高可及性。通过建立专家多学科监督委员会等监管创新,对于确保安全实施也至关重要。归根结底,CAR-T 疗法在LMIC中既是科学机遇,也是公共卫生机遇;其纳入医疗卫生系统有赖于协作策略,以解决资金、物流和政策障碍。本综述结合我们的经验,强调开发适应当地情况的解决方案,以在资源有限的环境中扩大先进细胞疗法可及性。

展开英文摘要原文

Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a transformative treatment for patients with relapsed or refractory hematologic malignancies, offering new possibilities beyond conventional transplantation. Since their approval in high-income countries, CAR-T products have demonstrated remarkable efficacy; however, their implementation in low- and middle-income countries (LMICs) remains limited due insufficient infrastructure, complex regulatory requirements and high costs. In some countries, like Mexico, these barriers are particularly pronounced, with limited access to clinical-grade vectors, early phase clinical research programs, and lack of government and private sector infrastructure and funding opportunities. Facing these challenges, there is a substantial patient population with B-cell acute lymphoblastic leukemia, multiple myeloma, or diffuse large B-cell lymphoma, who could benefit from CAR-T therapy.

Advances in point-of-care manufacturing within academic settings -particularly the use of closed, semi-automated systems- have demonstrated feasibility in LMICs, by reducing costs and simplifying procedures, while maintaining product quality. These approaches may provide a viable alternative to commercial products, with the potential to lower the economic burden and increase accessibility. Regulatory innovation with the establishment of expert multidisciplinary oversight committees, will also be critical to ensure safe implementation.

Ultimately, CAR-T therapy in LMICs is both a scientific and public health opportunity, and its integration into healthcare systems will depend on collaborative strategies that address financial, logistical, and policy barriers. By highlighting our experience, this review underscores the importance of developing locally adapted solutions to expand access to advanced cellular therapies in resource-constrained settings.

论文信息

作者
Quezada-Ramírez SI、Montelongo-Cepeda JE、González-López GA、Salazar-Riojas R、Alvarado-Navarro DM、Gómez-De León A、Gómez-Almaguer D
单位
Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, México.
文献类型
综述
期刊
Clinical hematology international2026
原文标识
PubMed 42388725 · DOI 10.46989/001c.163505