Current status and problems of chimeric antigen receptor T cell immunotherapy in treatment of hematological malignancies

国际输血及血液学杂志 Pub Date : 2020-01-20 DOI:10.3760/CMA.J.ISSN.1673-419X.2020.01.001

Yulin Xu, Yong-xian Hu, Xiangjun Zeng, Xiaohong Yu, He Huang

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Abstract

Some patients with hematologic malignancies as acute lymphoblastic leukemia (ALL), can achieve complete remission (CR) after chimeric antigen receptor T cell (CAR-T) immunotherapy. However, many constraints still limit the wide application of CAR-T immunotherapy in patients with hematological malignancies and other cancers, especially in patients with solid tumors. The main challenges related to CAR-T immunotherapy include: relapse caused by immune escape of tumor antigens, cytokine release syndrome (CRS), poor survival time in vivo, low infiltration capacity and inactivation of CAR-T in solid tumors, etc.. This article summarizes effects and problems of CAR-T immunotherapy in clinical trials for hematological malignancies, and how to use comprehensive treatment and biotechnology strategies to solve the current problems, in order to improve safety and effectiveness of CAR-T immunotherapy, and expand clinical benefits of CAR-T immunotherapy for patients with different tumors. Key words: Immunotherapy, adoptive; Receptors, chimeric antigen; Hematologic neoplasms; Chimeric antigen receptor-T cell; Solid tumors; Chimeric antigen receptor T cells immunotherapy; Combined modality therapy

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嵌合抗原受体T细胞免疫治疗血液系统恶性肿瘤的现状及问题

一些血液系统恶性肿瘤患者，如急性淋巴细胞白血病(ALL)，在嵌合抗原受体T细胞(CAR-T)免疫治疗后可以达到完全缓解(CR)。然而，许多限制因素仍然限制了CAR-T免疫疗法在血液系统恶性肿瘤和其他癌症患者，特别是实体肿瘤患者中的广泛应用。CAR-T免疫治疗面临的主要挑战包括:肿瘤抗原免疫逃逸引起的复发、细胞因子释放综合征(CRS)、体内生存时间差、CAR-T在实体瘤中的浸润能力低、失活等。本文综述了CAR-T免疫治疗在血液系统恶性肿瘤临床试验中的效果和存在的问题，以及如何利用综合治疗和生物技术策略解决当前存在的问题，以提高CAR-T免疫治疗的安全性和有效性，扩大CAR-T免疫治疗在不同肿瘤患者中的临床获益。关键词:免疫治疗;过继性;受体，嵌合抗原;血液肿瘤;嵌合抗原受体t细胞;实体肿瘤;T细胞免疫治疗;综合疗法

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来源期刊

国际输血及血液学杂志

自引率

0.00%

发文量

10610

期刊介绍： The International Journal of Transfusion and Hematology was founded in September 1978. It is a comprehensive academic journal in the field of transfusion and hematology, supervised by the National Health Commission and co-sponsored by the Chinese Medical Association, West China Second Hospital of Sichuan University, and the Institute of Transfusion Medicine of the Chinese Academy of Medical Sciences. The journal is a comprehensive academic journal that combines the basic and clinical aspects of transfusion and hematology and is publicly distributed at home and abroad. The International Journal of Transfusion and Hematology mainly reports on the basic and clinical scientific research results and progress in the field of transfusion and hematology, new experiences, new methods, and new technologies in clinical diagnosis and treatment, introduces domestic and foreign research trends, conducts academic exchanges, and promotes the development of basic and clinical research in the field of transfusion and hematology.