Allogeneic CD19-CAR-T cell infusion after allogeneic hematopoietic stem cell transplantation in B cell malignancies.
Allogeneic CD19-CAR-T cell infusion after allogeneic hematopoietic stem cell transplantation in B cell malignancies.
复制标题
同种异体CD19-CAR-T细胞输注B细胞恶性肿瘤中同种异体造血干细胞移植后。
DOI：
10.1186/s13045-017-0405-3
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发表时间：
2017-01-31
影响因子：
28.5
通讯作者：
Zhang C
中科院分区：
文献类型：
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作者：
Liu J;Zhong JF;Zhang X;Zhang C
异基因造血干细胞移植(allo-HSCT)被认为是治疗血液系统恶性肿瘤的基石。然而，allo-HSCT后血液病的复发仍然是一个挑战，并与较差的长期存活率相关。嵌合抗原受体重定向T细胞(CAR-T细胞)可导致复发/难治性血液系统恶性肿瘤患者的疾病缓解。然而，异基因造血干细胞移植后输注CAR-T细胞的治疗窗口及其疗效仍存在争议。在这篇综述中，我们首先讨论CAR-T细胞在allo-HSCT后复发病例中的应用。然后我们回顾了异基因造血干细胞移植后接受CAR-T细胞治疗的复发患者的毒性和移植物抗宿主病的发生情况。最后，我们回顾了临床试验登记和异基因造血干细胞移植后输注CAR-T细胞的治疗时间窗。同种异体CAR-T细胞治疗对异基因造血干细胞移植后复发的B细胞肿瘤患者是有益的，且毒性低，并发症少。然而，应进行样本量较大的多中心临床试验，以选择最佳治疗窗口并确认其疗效。
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered the cornerstone in treatment of hematological malignancies. However, relapse of the hematological disease after allo-HSCT remains a challenge and is associated with poor long-term survival. Chimeric antigen receptor redirected T cells (CAR-T cells) can lead to disease remission in patients with relapsed/refractory hematological malignancies. However, the therapeutic window for infusion of CAR-T cells post allo-HSCT and its efficacy are debatable. In this review, we first discuss the use of CAR-T cells for relapsed cases after allo-HSCT. We then review the toxicities and the occurrence of graft-versus-host disease in relapsed patients who received CAR-T cells post allo-HSCT. Finally, we review clinical trial registrations and the therapeutic time window for infusion of CAR-T cells post allo-HSCT. The treatment of allogeneic CAR-T cells is beneficial for patients with relapsed B cell malignancies after allo-HSCT with low toxicities and complications. However, multicenter clinical trials with larger sample sizes should be performed to select the optimal therapeutic window and confirm its efficacy.