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:PET/CT In paediatric lymphoma: Current role and advances.
PET/CT In paediatric lymphoma: Current role and advances.
氟-18 氟代脱氧葡萄糖([18F] FDG)PET/CT 已成为儿童淋巴瘤管理的核心手段,为分期、疗效评估和治疗调整提供关键信息。
氟-18 氟代脱氧葡萄糖([18F] FDG)PET/CT 已成为儿童淋巴瘤管理的核心,为分期、疗效评估和治疗调整提供关键信息。其融入国际临床试验和治疗方案,使应答适应策略得以实施,在改善结局的同时减少长期毒性,尤其是通过选择性省略早期应答者的放疗。除已确立的临床作用外,近期进展正在拓展 PET/CT 的能力。代谢肿瘤体积(MTV)和总病灶糖酵解(TLG)等定量生物标志物,比 SUVmax 等传统指标能更全面地评估疾病负荷。免疫治疗中的新兴应用,包括检查点抑制剂和 CAR-T 细胞治疗,凸显了 PET 在应答预测和治疗监测中不断演变的作用,尽管儿童特异性数据仍然有限。人工智能和影像组学正在引入自动化图像分析和风险分层的新方法,而剂量降低策略和 PET/MRI 等混合成像模式旨在尽量减少儿童的辐射暴露。此外,新型放射性示踪剂的发展,包括增殖和免疫靶向 agents,可能在未来进一步细化疾病表征。尽管有这些进展,重大挑战仍然存在,特别是在标准化、验证和转化为儿科临床实践方面。持续的合作研究和协调统一工作对于确保技术创新转化为淋巴瘤患儿结局的有意义改善至关重要。
Fluorine-18 fluorodeoxyglucose ([ 18 F] FDG) PET/CT has become central to the management of paediatric lymphoma, providing critical information for staging, response assessment, and treatment adaptation. Its integration into international clinical trials and treatment protocols has enabled response-adapted strategies that improve outcomes while reducing long-term toxicity, particularly through the selective omission of radiotherapy in early responders. Beyond its established clinical role, recent advances are expanding the capabilities of PET/CT. Quantitative biomarkers such as metabolic tumour volume (MTV) and total lesion glycolysis (TLG) offer more comprehensive assessment of disease burden than conventional metrics like SUVmax. Emerging applications in immunotherapy, including checkpoint inhibitors and CAR-T cell therapy, highlight the evolving role of PET in response prediction and treatment monitoring, although paediatric-specific data remain limited. Artificial intelligence and radiomics are introducing novel approaches for automated image analysis and risk stratification, while dose reduction strategies and hybrid imaging modalities such as PET/MRI aim to minimize radiation exposure in children. Additionally, the development of novel radiotracers, including proliferation and immune-targeted agents, may further refine disease characterization in the future. Despite these advances, significant challenges remain, particularly regarding standardization, validation, and translation into paediatric clinical practice. Continued collaborative research and harmonization efforts will be essential to ensure that technological innovations translate into meaningful improvements in outcomes for children with lymphoma.
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