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针对急性髓性白血病的CAR-T细胞疗法:我们现在站在哪里?

Pilar Lloret-Madrid^1,2, Pedro Chorão^1,2, Manuel Guerreiro^1,2

¹Hematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain.

Current oncology (Toronto, Ont.)

|June 25, 2025

概括

化学抗原受体T细胞 (CAR-T) 疗法在耐火性和复发性急性髓性白血病 (R/R AML) 中表现有前途. 它可以作为一座桥梁,用于全源造血干细胞移植 (allo-HSCT),以改善结果,尽管早期的挑战.

科学领域:

血液学血液学血液学
免疫治疗是一种免疫疗法.
在瘤学瘤学.

背景情况:

耐药性和复发性急性髓性白血病 (R/RAML) 是一个严重的临床挑战,预后不佳.
化学抗原受体T细胞 (CAR-T) 疗法是血液恶性瘤的新兴治疗方式.

研究的目的:

评估CAR-T治疗在R/RAML患者中的安全性和有效性.
分析关于R/RAML中CAR-T细胞治疗结果的临床证据.

主要方法:

2014年6月至2025年1月期间发表的针对R/RAML的CAR-T治疗临床试验的系统综述.
分析患者特征,CAR-T结构,响应率,与全源造血干细胞移植 (allo-HSCT) 进行整合,以及安全性概况.

主要成果:

分析了25项涉及296名患者的试验,针对的抗原包括CD33,CD123和CLL-1.
对CAR-T治疗的反应是可变的,通常是短暂的,没有alo-HSCT整合.
观察到可管理的细胞因子释放综合征和神经毒性;然而,长时间的骨髓抑制经常需要allo-HSCT.

结论:

卡特-T细胞疗法是R/RAML的潜在策略,特别是作为allo-HSCT的桥梁,以增强长期结果和减轻骨髓毒性.
仍然存在重要的疗效和安全障碍,需要在正在进行的临床试验中进一步调查.
针对R/RAML的CAR-T疗法开发处于起步阶段,解决了大量未满足的医疗需求.

关键词:

在CAR-T细胞疗法中.急性骨髓性白血病急性骨髓性白血病复发或不耐药的AML.

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