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预测B细胞急性淋巴细胞白血病CAR-T细胞治疗结果的生物标志物:系统性审查

Yanhao Ke¹, Fen Zhou¹

¹Department of Paediatric Hematology and Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Frontiers in immunology

|November 3, 2025

概括

像瘤负担和最小残留疾病这样的生物标志物预测CAR T细胞治疗在B-ALL中的成功. 识别这些标志物有助于个性化治疗和管理诸如CRS和神经毒性等副作用.

科学领域:

血液学血液学血液学
免疫学免疫学免疫学
在瘤学瘤学.

背景情况:

化学抗原受体 (CAR) T细胞疗法为复发/耐药B细胞急性淋巴细胞白血病 (B-ALL) 提供了有前途的治疗方法.
然而,包括细胞因子释放综合征 (CRS),免疫效应细胞相关的神经毒性 (ICANS) 和可变的长期疗效在内的挑战需要预测结果和风险分层的策略.

研究的目的:

本系统性审查旨在评估生物标志物在预测CAR T细胞治疗结果中的作用.
该研究还试图确定用于预测毒性风险和指导B-ALL患者个性化治疗策略的生物标志物.

主要方法:

在PubMed,Web of Science和Embase进行了系统的文献搜索,搜索了2018年至2024年间发表的研究,遵循PRISMA指南.
总共有33项研究,包括2095名患者,被纳入本分析.

主要成果:

瘤负担和最小残留疾病 (MRD) 成为关键预测生物标志物,高瘤负担与缓解率降低和毒性增加相关.
消极的MRD预测了优异的长期无事件生存率,而CAR-T功能参数,遗传标记和生化指标进一步分层了患者的风险.
特定的生物标志物如IL-6动态被确定用于预测CRS严重程度,T细胞子集表明治疗疗效.

结论:

生物标志物显示出在预测CAR T细胞治疗结果和B-ALL中毒性的显著潜力.
由于研究异质性和设计局限性的标准化挑战仍然存在.
未来的研究应该专注于综合预测模型的多中心验证和生物标志物引导的组合疗法,以优化个性化的CAR T细胞治疗.

关键词:

B细胞急性淋巴细胞白血病.在CAR-T细胞疗法中.生物标志物生物标志物细胞因子释放综合征最少残留疾病的最小残留疾病.系统性审查系统性审查瘤负担的增加

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