CD19嵌合抗原受体T细胞治疗后急性B淋巴细胞白血病的复发机制及对策防治

Mechanisms and countermeasures in relapse of B cell acute lymphoblastic leukemia after treatment of CD19 chimeric antigen receptor T cells

嵌合抗原受体T细胞(CAR-T)疗法是近年来发展迅速的一种新型细胞免疫疗法。多项临床试验均证实,CAR-T疗法可有效治疗多种复发/难治性(R/R)血液系统恶性疾病,其中CD19CAR-T治疗R/R急性B淋巴细胞白血病(B-ALL)患者的完全缓解(CR)率达70%~90%。但部分患者可在缓解后再次复发,这已成为影响CAR-T疗效的重要障碍之一。笔者拟就CD19CAR-T治疗R/RB-ALL后复发的可能机制及对策进行阐述。

Chimeric antigen receptor T cell (CAR-T) therapy is a new type of immunotherapy, which has been developed rapidly in recent years. A number of clinical trials have confirmed that CAR-T therapy can effectively treat a variety of relapsed/refractory (R/R) hematological malignancies. The available results show that 70%-90% of R/R B cell acute lymphoblastic leukemia (B-ALL) patients who receive CD19 CAR-T therapy achieve complete remission (CR). However, ALL can relapse in some patients who achieved CR, and relapse has become one of the obstacles affecting the efficacy of CAR-T. The article aims to summarizes the possible mechanisms and prevention strategies of R/R B-ALL relapse after CD19 CAR-T therapy.