供体来源嵌合抗原受体T细胞治疗血液系统恶性肿瘤移植后复发的研究进展

Progress of donor-derived chimeric antigen receptor T-cell immunotherapy for relapsed hematological malignancies after allogeneic hematopoietic stem cell transplantation

异基因造血干细胞移植（allo-HSCT）是治疗血液系统恶性肿瘤的重要手段,而移植后复发是allo-HSCT主要的并发症,也是目前患者移植后总生存（OS）率降低的主要原因.嵌合抗原受体T细胞（CAR-T）免疫疗法是一种疗效显著的针对恶性血液系统肿瘤的新兴治疗方法,而且随着研究的进展,CAR-T的安全性和有效性也在不断提高.研究发现移植后复发患者通过供体来源的CAR-T能够显著提高OS率,控制疾病的复发和进展.现综述近年来将供体来源CAR-T用于allo-HSCT后患者治疗的相关研究,并总结该治疗方法存在的问题及解决措施.

Allogeneic hematopoietic stem cell transplantation （HSCT） plays a key role in treatment of hematological malignancies. However, relapse of hematological malignancies is the main challenge of HSCT that causes significant declination of overall survival （OS） after HSCT. In recent years, the newly emerging chimeric antigen receptor T-cell （CAR-T） immunotherapy has obtained remarkable achievements in hematological malignancies, and with the progress of research, the safety and effectiveness of CAR-T are also increasing. Studies have found that donor-derived CAR-T can significantly increase OS rates in relapsed patients after transplantation through and control disease recurrence and progression. This review will focus on the efficacy and safety of donor-derived CAR-T in relapsed hematological malignancies after allo-HSCT, and summarize the main challenges to be resolved.