急性淋巴细胞白血病患者的CAR T细胞疗法:系统性审查和元分析
Victor Navarro1, Gloria Iacoboni2,3, Sergi Camarillas2
1Statistics unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
Bone marrow transplantation
|February 14, 2026
概括
化学抗原受体 (CAR) T细胞疗法显示了复发/耐药B细胞急性淋巴细胞白血病的高缓解率. 针对CD19的4-1BB CAR T细胞结构显示出卓越的疗效和安全性,改善了持久的反应.
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:
- 化学抗原受体 (CAR) T细胞疗法已经改变了复发性/耐药性 (R/R) B细胞急性淋巴细胞白血病 (B-ALL) 治疗.
- 响应的持续性仍然是一个重大挑战,在初始缓解后经常出现复发.
研究的目的:
- 在R/R B-ALL中系统地审查和元分析各种CAR T细胞结构的疗效和安全性.
- 评估患者人口统计学,先前治疗和构建特征对结果的影响.
主要方法:
- 40项临床试验的系统审查和元分析.
- 包括1540名R/R B-ALL患者.
- 评估完全缓解率 (CRR) 和最小残留病负完全缓解率 (MRDneg-CR/CRi).
主要成果:
- 聚合的CRR为83.4%;聚合的MRD-neg-CR/CRi比率为92.7%.
- 4-1BB协同刺激域结构产生了较高的MRD-neg-CR/CRi率 (94.0%) 与CD28 (84.4%),神经毒性事件较少.
- 针对CD19或CD19/CD22的CAR T细胞与针对CD22的治疗相比,显示出优异的MRD-neg-CR/CRi率.
结论:
- 针对CD19的基于4-1BB的CAR T细胞疗法对R/R B-ALL.具有最佳的疗效和安全性.
- 优化CAR T细胞结构对于增强持久反应和患者结果至关重要.
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