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CD19嵌合抗原受体修饰的T细胞治疗B细胞系急性淋巴细胞白血病

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发表于 2015-11-24 22:05:53 | 显示全部楼层 |阅读模式
CD19 chimeric antigen receptor T cell therapy for the treatment of B cell lineage acute lymphoblastic leukemia.

Abstract
Relapsed and refractory acute lymphoblastic leukemia (ALL) remains difficult to treat, with minimal improvement in outcomes despite advances in upfront therapy and improved survival for de novo ALL. Targeted immunotherapy for cancer represents a promising new treatment and utilizing the immune system to target and eradicate malignant cells in the body has emerged as a potent therapy. Administration of cytotoxic T cells genetically engineered to express a chimeric antigen receptor (CAR) recognizing CD19 have been shown to induce complete responses in patients with B-cell lineage ALL. So far, six clinical trials including 79 ALL patients treated with CD19-CAR T cells have been published, and the results from these trials are exciting with impressive clinical responses. Thus, CAR T cell therapy represents a potential useful tool to ALL. However, the majority of CAR cell studies have observed severe therapy associated toxicities, which needs attention. In this review, we mainly focus on CD19-CAR T cells, clinical trials for ALL as well as toxicities and challenges for CD19-CAR T therapy.


CD19嵌合抗原受体修饰的T细胞治疗B细胞系急性淋巴细胞白血病
摘要:
复发难治性急性淋巴细胞白血病(ALL)仍难以治疗,在ALL治疗方面,虽然在前期治疗和改善生存方面有一些优势,但是进展仍然很小。靶向免疫治疗癌症是一种很有前途的新的治疗方法,利用免疫系统靶向和摧毁体内的恶性细胞已经成为一种很有潜力的治疗。具有杀伤毒性并通过修饰表达嵌合抗原受体,能够识别CD19T细胞疗法已经对B细胞系急性淋巴细胞白血病患者展现了完全的治疗效果。到目前为止,6个包含了79ALL的利用CD-19CAR-T细胞治疗的临床试验结果已经发布,这些临床试验也有令人鼓舞的治疗效果。因此,CAR-T细胞疗法代表了一种对抗ALL有用的治疗工具。然而,大多数的CAR-T细胞疗法观察到一些与治疗相关的毒性,需要引起重视。在这篇综述中,我们关注的是CD19修饰的CAR-T细胞,ALL的临床试验,以及CD19CAR-T细胞治疗的毒副作用和挑战。

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