在T细胞淋巴细胞白血病/淋巴瘤中使用CAR-T细胞疗法:我们现在处于何处?
Pedro Chorão1,2, Pilar Lloret1,2, Pau Montesinos1,2,3
1Hematology Department, Hospital Universitari i Politècnic La Fe, València, Spain.
Expert review of anticancer therapy
|June 3, 2025
概括
卡尔-T细胞疗法显示了复发/耐药T细胞白血病/淋巴瘤的高缓解率. 诸如移植与宿主疾病和感染等挑战仍然存在,需要标准化报告以改善结果.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 血液学 血液学 血液学
背景情况:
- 再发性或耐药性 (r/r) T 细胞淋巴细胞白血病/淋巴瘤 (T-LL/L) 存在重大治疗挑战.
- 现有的临床研究通常很小,分散,包括临床前数据,阻碍了明确的疗效和安全性评估.
研究的目的:
- 专门审查针对r/r T-LL/L.L.的CAR-T疗法的临床研究.
- 在这个患者群体中评估不同CAR结构的安全性和有效性.
主要方法:
- 从2014年6月到2024年6月对临床试验数据库,注册表和会议摘要进行系统审查.
- 不包括临床前研究和缺乏临床细节的研究.
- 对患者人口统计,CAR-T特征,反应率,生存率和不良事件的分析.
主要成果:
- 确定了11个针对CD7和2个针对CD5的CAR-T结构.
- 完全缓解率在55%至100%之间 (在大多数研究中超过80%).
- 复发率各不相同 (7-66%),并指出了外骨髓性复发. 细胞因子释放综合征和神经毒性是可控的;GVHD发病率不同 (0-60%),感染导致了与治疗相关的死亡率的6-38%.
结论:
- 卡特-T疗法在r/r T-LL/L中显示出高响应率,可能成为通用移植的桥梁.
- 担忧包括短期随访,反应持续时间,GVHD,免疫恢复和感染控制.
- 标准化报告对于优化未来的CAR-T治疗结果和安全性至关重要.
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