结合CAR T细胞疗法和尼沃卢马布来克服THRLBCL的免疫抵抗:一个案例报告
Daniel Munarriz1, Oriana López-Godino2, Nuria Martinez-Cibrian1,3
1Department of Hematology, Hospital Clínic, 08036 Barcelona, Spain.
International journal of molecular sciences
|October 16, 2025
概括
富含T细胞/白细胞的大型B细胞淋巴瘤 (THRLBCL) 是具有攻击性的. 结合CAR T细胞疗法与PD-1/PD-L1阻塞克服了耐药性,并在一个耐火病例中实现了长期缓解.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
背景情况:
- 富含T细胞/细胞的大B细胞淋巴瘤 (THRLBCL) 呈现出一种免疫抑制性瘤微环境.
- 瘤细胞PD-L1过度表达是一种免疫逃生机制,可能导致对CAR T细胞疗法的抗性.
研究的目的:
- 报告一种耐火性THRLBCL病例,该病例接受了抗CD19CART细胞治疗.
- 调查PD-L1在CAR T细胞耐药性的作用,并评估结合免疫检查点阻塞的疗效.
主要方法:
- 一名患有耐火性IV-B阶段THRLBCL的患者接受了抗CD19CAR T细胞治疗.
- 治疗后的分析包括周围血液细胞计数,骨髓活检和PD-L1表达的免疫组织化学.
- 在疾病进展后,用尼沃卢马布启动了免疫检查点封锁.
主要成果:
- 对CAR T细胞治疗的初始反应随后是疾病进展.
- 在CAR T细胞治疗后观察到PD-L1表达的增加,这表明适应性免疫抵抗.
- 与尼沃卢马布的联合治疗导致了完全的代谢反应和持续缓解四年.
结论:
- PD-1/PD-L1阻塞可以克服THRLBCL中的CAR T细胞抵抗.
- 这种协同方法在治疗类似的免疫逃避策略的B细胞恶性瘤方面是有前途的.
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