移植后淋巴增殖性疾病的靶向药物治疗

Targeted therapy of post-transplant lymphoproliferative disease

移植后淋巴增殖性疾病(PTLD)是一组发生在各种器官移植或造血干细胞移植后淋巴细胞异常增殖的疾病,严重影响患者存活率及移植成功率。治疗方法主要有减少免疫抑制剂的使用,联合化疗,使用EB病毒特异性细胞毒性T淋巴细胞,去B淋巴细胞治疗,靶向抑制剂等,但其各有缺点。以利妥昔单抗为代表的靶向药物治疗因其有特定的靶向性而具有疗效好、不良反应小的优势,可能成为PTLD预防和治疗的新选择。由于这类药物仍需临床研究证实,资料有限,现就靶向抑制剂治疗淋巴增殖性疾病作一总结。

Post-transplant lymphoproliferative disease(PTLD)results from the uncontrolled proliferation of lymphocytes after hematopoietic stem cell transplantation and solid organ transplantation.PTLD greatly reduces the survival of both patients and grafts.The treatments for PTLD include reducing the use of immunosuppressive agents,chemotherapy,EB virus-specific cytotoxic T lymphocytes(CTL),B lymphocyte depletion therapy,targeted inhibitors,etc.However,all of them have shortages.Specific biological target drugs aiming at a certain link in the pathogenesis of PTLD show a good curative effect and small adverse reactions,and thus serve as new options for its prevention and treatment.Because of the limited data,clinical studies are still needed to confirm these drugs.In this article,the application of targeted therapy in the treatment of PTLD was summarized.