[在老年患者的第一次复发时发生了brexu-cel的病例.]
Marco Cerrano1, Lorenzo Celona1, Giulia Berutto1
1SC Ematologia, Aou Città della Salute e della Scienza di Torino.
Recenti progressi in medicina
|January 22, 2026
概括
在65岁以上的复发性B细胞急性淋巴细胞白血病患者中,Brexu细胞CAR-T疗法实现了持久的缓解. 这种免疫疗法为患有复杂B-ALL的老年人提供了可行的选择,即使有并发症.
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:
- 复发或耐药的B细胞急性淋巴细胞白血病 (R/R B-ALL) 存在重大治疗挑战.
- 免疫疗法,特别是CAR-T细胞疗法,已经成为成人R/R B-ALL的转变性治疗方法.
- 卡特-T细胞疗法提供了新的希望,具有高缓解率和持久的反应.
研究的目的:
- 评估乳腺细胞CAR-T治疗在患有R/R B-ALL和并发症的老年患者中的疗效和安全性.
- 在复杂的患者群体中评估Brexu-cel治疗的长期结果.
- 突出CAR-T治疗在R/R B-ALL的老年人中的潜力.
主要方法:
- 一名67岁的女性患者患有费城阴性B-ALL和并发症,接受了诱导疗法,维护疗法,然后是乳腺细胞CAR-T疗法.
- 在CAR-T输液注入之前,使用伊诺图祖马布进行过桥疗法.
- 密切监测患者的反应,包括最小残留疾病 (MRD) 状态和不良事件.
主要成果:
- 患者在布雷克素细胞治疗后实现了完全MRD阴性缓解.
- 布雷克苏细胞治疗与可控毒性相关,包括1级细胞因子释放综合征 (CRS) 和1级免疫效应细胞相关神经毒性综合征 (ICANS).
- 患者在治疗后一年以上的时间内保持了完全的MRD阴性缓解,没有进一步的治疗.
结论:
- 布雷克苏塞尔是治疗R/R B-ALL的有效治疗方法,即使是在患有并发症的老年患者中也是如此.
- 在高风险患者中,使用brexu-cel可以在没有额外的整合疗法的情况下实现长期缓解.
- 优化的桥梁治疗,警监测和积极的毒性管理对于成功的CAR-T治疗结果至关重要.
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