改善了慢性淋巴细胞白血病患者的先天免疫功能,在临床试验中接受了向治疗
Rebecca Svanberg Teglgaard1, Hanne Vibeke Marquart2, Hans Jakob Hartling2
1Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
概括
针对慢性淋巴细胞白血病 (CLL) 的向治疗恢复了先天免疫功能,并降低了感染风险. 这项研究表明,acalabrutinib和ibrutinib+venetoclax可以改善CLL患者的免疫反应.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 患有慢性淋巴细胞白血病 (CLL) 的患者面临严重感染的高风险.
- 虽然已知适应性免疫功能障碍,但预测感染风险的工具有限.
- 向疗法可以保护或增强先天免疫功能,与化疗不同.
研究的目的:
- 在向治疗前和治疗期间调查CLL患者的先天性免疫表型和功能.
- 评估像acalabrutinib或ibrutinib+venetoclax这样的向药物是否会影响先天免疫力.
- 为了将免疫变化与CLL患者的感染发病率相关联.
主要方法:
- 从用acalabrutinib (n=17) 或ibrutinib+venetoclax (n=18) 治疗的CLL患者收集的血液样本.
- 使用 TruCulture 评估天生的免疫功能,这是全血细胞因子释放试验.
- 通过流式细胞计量来表征免疫细胞表型,并跟踪抗菌素的使用作为感染的代理.
主要成果:
- 基线CLL患者表现出细胞因子反应受损,单细胞失活,炎症性细胞因子升高.
- 两到三个周期的acalabrutinib或ibrutinib正常化了反应和减少了感染持续时间.
- 长期治疗导致免疫特征进一步正常化,感染频率降低.
结论:
- 向治疗恢复了先天的免疫功能,并降低了CLL患者的感染易感性.
- 阿卡拉布鲁丁尼和易布鲁丁尼+韦内托克拉克斯显示出降低感染风险的潜力.
- 目前正在进行的试验正在进一步调查这些针对高风险的CLL的向治疗方法.
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