新药时代下如何为异基因造血干细胞移植赋能

Improvement of hematopoietic stem cell transplantation in the targeted therapy era

造血干细胞移植是治愈血液肿瘤的手段之一,异基因造血干细胞移植技术在我国发展迅速,形成了许多具有中国特色的移植方案和技术体系,尤其是单倍型造血干细胞移植的成熟运用,基本解决了供者来源受限的问题。表观遗传调控药物、靶向白血病关键通路及免疫细胞疗法的不断涌现,为血液肿瘤治疗提供了新选择,也为造血干细胞移植提供了新的赋能手段。本文对新药在异基因造血干细胞移植全程(移植前、中、后)的应用及相关临床新技术、新方案进行总结,认为靶向药物等新药与造血干细胞移植更加紧密地联合是进一步提高移植疗效、增加安全性的有效方法;将现有的造血干细胞移植技术与新药有机地整合出最佳方案,以进一步提升疗效并提高患者生存质量,是今后该领域研究须重点关注的问题。

Hematopoietic stem cell transplantation(HSCT)is one of best ways to treat hematological malignancies.And,allogeneic HSCT has been developing rapidly in our country within recent decades,and accomplished many transplantation schemes and technological systems with Chinese characteristics.Especially,the mature application of haplo-identical HSCT promotes the transplantation into an era of“everyone has a donor”.Nowadays,constantly emerged epigenetic regulators,pathway modulators of leukemia genesis and immune cell therapies have provided more options for physician and patients so far in HSCT.In this article,we summarize the application of new drugs in the whole process of allogeneic HSCT(before,during and after transplantation)and related new technologies and new schemes.We consider that the closer combination of new drugs such as targeted drugs and HSCT is an effective measure to further improve the efficacy and safety of allogeneic HSCT.We should organically integrate the existing technologies and new drugs into the best scheme in order to further enhance the efficacy and improve the quality of life of patients.This is a problem that must be focused on in this field in the future.