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
自体干细胞移植治疗继发性中枢神经系统淋巴瘤：一项多中心回顾性分析
英文原题：Autologous stem cell transplantation for secondary central nervous system lymphoma: a multicentre retrospective analysis.
查看英文原题
Autologous stem cell transplantation for secondary central nervous system lymphoma: a multicentre retrospective analysis.
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研究概要
我们的数据表明，在继发性 CNSL 中，化疗敏感性很可能通过基于塞替派的巩固性 ASCT 带来良好结局。相反，对挽救化疗反应不佳的患者可考虑包括 CAR-T 细胞疗法在内的替代方案。
研究思路结论见上方概要
背景
继发性中枢神经系统淋巴瘤（SCNSL）是一种侵袭性淋巴瘤，预后较差。关于采用以塞替派为基础的自体移植（ASCT）进行巩固治疗SCNSL，目前尚缺乏共识。
方法
我们的回顾性新加坡研究考察了2013年至2024年间在两家三级癌症中心接受ASCT的27例SCNSL患者（中位年龄57岁）的生存结局。
结果
5例（18.5%）患者为新发SCNSL，14例（51.9%）患者为孤立性CNS复发性SCNSL，8例（29.6%）患者为同步复发性SCNSL。在ASCT时，分别有16例（59.3%）、7例（25.9%）和4例（14.8%）患者处于CR、PR和SD/PD。22例复发性SCNSL患者的中位随访时间为63（5-109）个月，中位PFS和OS分别为11.5个月和30个月，4年PFS和OS率分别为35.0%和48.0%。在我们的分析中，与男性相比，女性表现出更优的中位和4年PFS及OS，这可能与年龄和体能状态的差异有关。在多变量分析中，ASCT时达到CR/PR倾向于改善OS（HR 7.86，p = 0.06），尽管这未达到统计学显著性。
展开英文摘要原文
BACKGROUND
Secondary Central Nervous Lymphoma (SCNSL) is an aggressive lymphoma with poor outcomes. Consensus regarding consolidation with thiotepa-based autologous transplant (ASCT) for SCNSL is lacking.
METHODS
Our retrospective Singapore study examined survival outcomes post ASCT in 27 patients (median age 57 years) with SCNSL in two tertiary cancer centres from 2013 to 2024.
RESULTS
Five (18.5%) patients had de novo SCNSL, 14 (51.9%) patients had isolated CNS relapsed SCNSL and 8 (29.6%) patients had synchronous relapsed SCNSL. At the time of ASCT, 16 (59.3%), 7 (25.9%) and 4 (14.8%) patients were in CR, PR and SD/PD respectively. Median follow up for the 22 relapsed SCNSL patients was 63 (5-109) months with a median PFS and OS of 11.5 and 30 months, respectively, and 4-year PFS and OS rates of 35.0% and 48.0%, respectively. In our analysis, females demonstrated superior median and 4-year PFS and OS compared to males, likely related to difference in age and performance status. On multivariate analysis, CR/PR at time of ASCT trended toward an improved OS (HR 7.86, p = 0.06) although this was not statistically significant.
CONCLUSION
Our data suggests that in secondary CNSL, chemo-sensitivity would likely confer good outcomes with thiotepa-based consolidation ASCT. Conversely, patients responding poorly to salvage chemotherapy may consider alternatives including CAR-T cell therapy.
论文信息
- 作者
- Tan MW、Ling V、Tan JY、Chan WL、Thong E、Nagarajan C、Ong SY、Chen Y
- 第一作者单位
- Department of Haematology, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.Singapore
- 通讯作者单位
- Department of Haematology, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore. Lawrence.ng.c.k@singhealth.com.sg.Singapore
- 期刊
- BMC cancer2026 Jul 14
- 原文标识
- PubMed 42449282 · DOI 10.1186/s12885-026-16531-z