急性白血病免疫治疗的临床经验与前景  

Immunotherapy of acute leukemia:clinical experience and prospect

作　　者：童春容[1] 

机构地区：[1]河北燕达陆道培医院血液科,河北省廊坊市065201

出　　处：《中国肿瘤临床》2017年第6期249-252,共4页Chinese Journal of Clinical Oncology

摘　　要：近年来,急性白血病(acute leukemia,AL)的免疫治疗已获得一些突破性进展。本文旨在总结AL免疫治疗的结果和经验,如抗CD19抗原嵌合受体基因工程修饰T细胞、抗CD3/19双特异抗体治疗,使部分难治复发急性B淋巴细胞白血病(refractory relapse acute B lymphocytic leukemia,r/r B-ALL)获得完全缓解(complete remission,CR)。本研究团队采用化疗联合自体细胞因子诱导的杀伤细胞、自然杀伤细胞,明显提高第一次CR期中低危险性AL的长期无病生存率(disease-free survival,DFS)。其他多种免疫治疗方法的研究也逐步开展,如针对其他靶点的抗原嵌合受体基因工程修饰T细胞、T细胞抗原受体基因修饰的T细胞,其他靶点的双特异性抗体、针对免疫细胞周期卡控点的抗体或药物等。多种免疫治疗及方法的联合有望提高AL的治愈率及生存质量,从而减少采用对生存质量影响更大的异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,Allo-HCT)的治疗方法。Breakthroughs in the immunotherapy of acute leukemia have been achieved in recent years. The paper summarizes the clinical results, experience, and prospect in this area. One of the most significant advancements is the finding that anti-CD19 chimeric anti-gen receptor T cells （CAR-T） or CD3/CD19 bispecific antibody increases the rate of complete remission in patients with refractory re-lapse acute B lymphocytic leukemia. The disease-free survival of patients with low or intermediate risk was dramatically improved by combining chemotherapy and adoptive cytokine-induced killer or natural killer cells. Many immunotherapy methods, such as those fo-cusing on other targets of CAR-T, T-cell antigen receptor-modified T cell, and other targets of bispecific antibodies, are currently being examined. Combined methods can further increase cure rate and improve patients＇ quality of life, decreasing application of allogeneic hematopoietic cell transplantation which increases risks and reduces the quality of life.

关 键 词：急性白血病 免疫治疗 临床结果 经验 前景 

分 类 号：R733.71[医药卫生—肿瘤]