在不适合CAR T细胞治疗的患者中治疗初级耐火扩散大B细胞淋巴瘤的管理
Santino Caserta1, Enrica Antonia Martino1, Mamdouh Skafi2
1Department of Onco-Hematology, Hematology Unit, AO of Cosenza, Cosenza, Italy.
European journal of haematology
|March 7, 2026
概括
对于不耐受性扩散型大B细胞淋巴瘤患者,不适合CAR T细胞治疗,新型基于抗体的治疗方法,包括双特异性抗体,为疾病控制和潜在恢复CAR T细胞资格提供了有效的替代方案.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 主要耐火扩散大B细胞淋巴瘤 (DLBCL) 呈现出不良预后和对传统救援治疗的反应有限.
- 化学抗原受体 (CAR) T细胞治疗是复发/耐药DLBCL的标准,但由于临床,后勤或社会因素,许多患者不适合.
研究的目的:
- 审查DLBCL患者不适合CAR T细胞治疗的替代治疗策略.
- 突出基于抗体的新型疗法和双特异性抗体在治疗这些患者中的作用.
主要方法:
- 对初级耐火DLBCL治疗选择的当前文献的综述.
- 分析传统救援方案,基于抗体的疗法和双特异性抗体的疗效和耐受性.
主要成果:
- 传统的治疗方案提供短期控制,但缺乏持久性.
- 新型抗体疗法 (polatuzumab,loncastuximab tesirine,tafasitamab/lenalidomide) 改善了治疗结果和耐受性.
- CD20 × CD3双特异性抗体提供现成的,门诊患者友好的免疫参与.
结论:
- 早期识别CAR T细胞资格障碍至关重要.
- 及时使用双特异性抗体或其他基于抗体的疗法可以实现快速的疾病控制,保持器官功能,并可能使未来的CAR T细胞治疗成为可能.
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