在接受布洛利祖马布治疗后患有血质恶性病的参与者身上进行异性干细胞移植
John Kuruvilla1, Philippe Armand2, Alex F Herrera3
1Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.
Transplantation and cellular therapy
|March 5, 2025
概括
在抗编程细胞死亡蛋白1 (PD-1) 治疗后,全基性干细胞移植 (allo-SCT) 显示出良好的结果. 这种方法是血液性恶性瘤的可行的救援选择,可控的移植对宿主疾病和低的移植相关死亡率.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 全基性干细胞移植 (allo-SCT) 是血液恶性瘤的关键治疗方法.
- 在使用alo-SCT之前使用抗编程细胞死亡蛋白1 (PD-1) 疗法,这引发了关于安全性和有效性的问题.
- 了解结合抗PD-1疗法和allo-SCT后的结果对于临床决策至关重要.
研究的目的:
- 评估在两年内接受抗PD-1疗法 (pembrolizumab) 的患者中allo-SCT的安全性和有效性.
- 评估关键结果,包括移植与宿主疾病 (GVHD),无进展生存率 (PFS),总生存率 (OS),移植相关死亡率 (TRM) 和复发.
主要方法:
- 分析了四项临床试验 (KEYNOTE-013, -087, -170, -204) 的70名参与者的数据.
- 参与者在最后一剂 pembrolizumab 剂量后的两年内接受了 allo-SCT.
- 对急性和慢性GVHD,PFS,OS,TRM和复发率的评估.
主要成果:
- 六个月的II-IV级急性GVHD的累计发病率为41%,III-IV级为20%.
- 慢性GVHD的一年发生率为19%.
- 在40个月后,PFS为56.8%,OS为76.5%,TRM率低 (17%) 和复发率低 (27%). 这些结果是有利的,特别是在古典霍奇金淋巴瘤患者.
结论:
- 急性和慢性GVHD的发生率处于预期范围之内.
- 观察到有利的PFS和OS结果,加上低TRM和复发率.
- 在血液恶性瘤的抗PD-1治疗后,Allo-SCT是一种可行的和有效的救援疗法选择.
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