在一线慢性淋巴细胞白血病中使用IBRUTINIB加VENETOCLAX进行免疫恢复:第二期CAPTIVATE研究
Carol Moreno1, Isabelle G Solman2, Constantine S Tam3
1Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Josep Carreras Leukaemia Research Institute, Barcelona, Spain.
Blood advances
|June 14, 2023
概括
慢性淋巴细胞白血病 (CLL) 的一线易布鲁替尼加维尼托克拉克斯治疗恢复了正常的免疫细胞数量. 这种治疗导致持续的CLL细胞消除和免疫系统恢复.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 慢性淋巴细胞白血病 (CLL) 是一种B细胞恶性瘤.
- 治疗ibrutinib和venetoclax的目的是消除CLL细胞并恢复免疫功能.
- 评估最小残留疾病 (MRD) 对于评估治疗反应至关重要.
研究的目的:
- 评估CLL患者的免疫细胞子集恢复,这些患者接受一线IBRUTINIB加VENETOCLAX治疗.
- 在治疗期间和治疗后,将免疫细胞水平与健康供体水平 (HDL) 进行比较.
- 评估固定时间治疗对免疫复原的影响.
主要方法:
- 在7个时间点对来自CAPTIVATE研究 (NCT02910583) 的免疫细胞子集的分析.
- 患者样本与年龄相匹配的健康捐赠者进行比较.
- 根据MRD状态随机分配给安慰剂,易布鲁替尼或易布鲁替尼加维尼托克拉克斯治疗后.
主要成果:
- 开始服用venetoclax后,CLL细胞水平显著下降,到第16周期时接近HDL.
- 在被随机分配给安慰剂的患者中,正常的B细胞恢复到HDL.
- 在治疗后6个月内,T细胞,单细胞和树突细胞正常化.
- 等离子体树突细胞在20个周期内显著恢复.
- 随着时间的推移,感染减少,在安慰剂组数量上最低.
结论:
- 固定的持续时间的易布鲁替尼加维内托克拉克斯治疗导致持续的CLL细胞消除.
- 治疗促进恢复正常的血液免疫细胞组成.
- 免疫复制支持长期缓解和改善患者结果的潜力.
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