嵌合抗原受体型T细胞在血液肿瘤中的研究进展

Research Progress on Chimeric Antigen Receptor T-cell in Hematological Malignancies

目的嵌合抗原受体T细胞(chimeric antigen receptor T-cell,CAR-T)是从患者的血液或肿瘤组织中提取出T淋巴细胞,通过基因工程技术,采用特异性CAR基因转染后,进行体外培养增殖,进而产生一种抗肿瘤细胞。本研究总结关于CAR-T技术与血液恶性肿瘤研究现状,探讨其对血液肿瘤治疗的效果。方法以"嵌合抗原受体型T细胞、嵌合抗原受体型T细胞与肿瘤生物治疗、嵌合抗原受体型T细胞与血液肿瘤"为关键词,应用PubMed及CNKI期刊全文数据库检索系统,检索2000-01-2016-03相关文献,共检索到文献520篇。以"CAR-T的生物合成、CAR-T的作用机制、CAR-T细胞在血液肿瘤中的治疗以及CAR-T细胞临床应用研究方向"为纳入标准,符合条件的文献共有42篇。结果CAR-T细胞是通过基因修饰的方法获得的针对肿瘤细胞表面特定抗原的特异性T细胞,CAR-T细胞具有强大的抗肿瘤效果,可以在体内特异性识别并杀死肿瘤细胞。其对肿瘤细胞的识别作用是由CAR结构所决定。目前,CAR-T细胞技术常用于治疗血液肿瘤,尤其对于B细胞恶性肿瘤的治疗展现出良好的效果,并且对Ph+的高危患者和造血干细胞移植后复发的患者同样有效。结论 CAR-T细胞可能成为治疗血液恶性肿瘤的一种重要手段。

OBJECTIVE Chimeric antigen receptor T-cell are some reformed T cells from blood or tumor tissues of patients. These T cells are transfected with chimeric antigen receptor（CAR） gene by technique for gene engineering, then cultivated and amplified sufficiently in vitro to get the ability to kill the tumor cell. This article summaries the research progress of CAR-T in hematological neoplasms, to investigate the effect of CAR-T in the treatment of hemotological neo- plasms. METHODS Based on Pubmed and CNKI Journal Full-text Database Retrieval Systems, literatures were searched with the keywords of ＂CAR-T, CAR-T and neoplasm biotherapy, CAR-T and hematological malignancies＂ from January 2000 to March 2016, and a total of 520 articles were obtained. Totally 42 papers were selected according to the criteria of ＂biosynthesis of CAR-T, mechanism faction of CAR-T, CAR-T cells therapy in hematological neoplasms and clinical research progress on CAR-T in malignancies＂. RESULTS CAR-T cells are reformed by gene engineering. These cells can acquire specific receptor to aim directly at neoplastic antigen reformed by gene engineering. CAR-T cells possess great power to treat tumor, can specifically recognize and destroy malignant cells. The recognition function depending on CAR section. Currently, the technology is used in treating hematological malignancies, and reveals satisfactory result especially in I3 cell malignant neoplasm. Moreover, this therapy has the same effect in high risk patients with Philadelphia chromosome-positive （Ph＋） disease and relapsed disease after previous allo-HSCT. CONCLUSION CAR-T cells can be quite important therapy of hematological neoplasms.