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2015年CLL细胞治疗的加速器:异体细胞移植技术与CARs

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发表于 2015-12-27 23:20:13 | 显示全部楼层 |阅读模式
A drive through cellular therapy for CLL in 2015: allogeneic cell transplantation and CARs.
Abstract
Over the past decade the development of safer reduced-intensity conditioning regimens, expanded donor pools, advances in supportive care, and prevention/management of graft-versus-host disease have expanded stem cell transplantation (SCT) availability for chronic lymphocytic leukemia (CLL) patients. However, there are now increasingly active treatment options available for CLL patients with favorable toxicity profiles and convenient administration schedules. This raises the critical issue of whether or not attainment of cure remains a necessary goal. It is now less clear that treatment with curative intention and with significant toxicity is required for long-term survival in CLL. In addition, the demonstrated safety and activity of genetically modified chimeric antigen receptor (CAR) T cells present the opportunity of harnessing the power of the immune system to kill CLL cells without the need for SCT. We attempt to define the role of SCT in the era of targeted therapies and discuss questions that remain to be answered. Furthermore, we highlight the potential for exciting new cellular therapy using genetically modified anti-CD19 CAR T cells and discuss its potential to alter treatment paradigms for CLL.
2015CLL细胞治疗的加速器:异体细胞移植技术与CARs
摘要:
在过去的十年内,更加安全的降低预处理方案的发展、扩大捐献来源、支持护理的进步、预防/管理移植物抗宿主病等方面,使得慢性淋巴细胞白血病患者(CLL)接受干细胞移植(SCT)的有效性得到了很大的进步。然而,目前也有很多治疗观点用于CLL病人,有良好的毒性控制和方便的管理进程。这引发了一个关键的问题,能否治愈CLL仍然是一个必要的目标。目前也不清楚,根治CLL与明显的副作用是否是CLL病人长期生存所必须的。此外,CAR-T细胞治疗技术的有效性和安全性代表着有机会利用免疫系统来杀死CLL细胞,而不需要通过干细胞移植技术。我们尝试去界定SCT在靶向治疗技术中的地位,讨论需要被解决的问题。进一步,我们将会重视使用CD19 靶向的CAR-T细胞这种激动人心的技术,并且讨论这种靶向治疗CLL病人技术的潜力。
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