【摘要】：難治復(fù)發(fā)急性淋巴細(xì)胞白血病(acute lymphocytic leukemia,ALL)預(yù)后差,生存期短,其治療已成為國(guó)際難題。嵌合抗原受體基因修飾T(chimeric antigen receptor gene-modified T,CAR-T)細(xì)胞是目前最具應(yīng)用前景的靶向免疫治療,靶向CD19的CAR-T細(xì)胞(CD19-CAR-T)治療兒童及成人難治復(fù)發(fā)性ALL的完全緩解率(complete remission,CR)可達(dá)90%以上,療效遠(yuǎn)高于化療。然而,細(xì)胞因子釋放綜合征(cytokine release syndrome,CRS)、嚴(yán)重神經(jīng)毒性(serious neurotoxicity,SNT)、脫靶效應(yīng)以及疾病復(fù)發(fā)等嚴(yán)重限制了CAR-T細(xì)胞的進(jìn)一步臨床應(yīng)用。本文主要闡述CAR-T細(xì)胞的制備技術(shù)、預(yù)處理方案、細(xì)胞輸注劑量及各種并發(fā)癥防治策略等最新研究進(jìn)展。
[Abstract]:The treatment of refractory recurrent acute lymphoblastic leukemia (acute lymphocytic leukemia,ALL) has become an international problem because of its poor prognosis and short survival time. Chimeric antigen receptor gene modified T (chimeric antigen receptor gene-modified-T cells are the most promising target immunotherapy at present. The complete remission rate (complete remission,CR) of CAR-T cells (CD19-CAR-T) targeting CD19 in the treatment of refractory and recurrent ALL in children and adults was more than 90%, and the curative effect was much higher than that in chemotherapy. However, cytokine-releasing syndrome (cytokine release syndrome,CRS), severe neurotoxicity (serious neurotoxicity,SNT), off-target effect and relapse seriously limit the further clinical application of CAR-T cells. In this paper, the recent advances in the preparation of CAR-T cells, pretreatment schemes, dose of cell infusion and prevention and treatment strategies of various complications were reviewed.
【作者單位】： 浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院骨髓移植中心;
【基金】：國(guó)家重點(diǎn)基礎(chǔ)研究發(fā)展計(jì)劃(973計(jì)劃)基金項(xiàng)目(No.2015CB964900)~~
【分類(lèi)號(hào)】：R733.71
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本文編號(hào)：2463716