CAR-T细胞治疗血液肿瘤的临床进展

Clinical Progress of CAR-T Cell Therapy for Hematologic Malignancies

嵌合抗原受体T细胞(chimeric antigen receptor T cell,CAR-T)是一种新型治疗型T细胞,通过基因工程在T细胞表面表达可识别特定肿瘤抗原的嵌合受体,能特异性杀伤肿瘤细胞。CAR-T在多种血液肿瘤的治疗中具有良好的应用前景,受到了广泛的关注,但越来越多的临床应用显示CAR-T治疗产生了一系列不良反应,不同程度影响患者预后。该文总结了CAR的结构设计演变,CAR-T在急性淋巴细胞白血病、急性髓系白血病、淋巴瘤和多发性骨髓瘤中的应用及相关不良反应,并就如何提高CAR-T的疗效和安全性展开讨论。

As a new type of cellular therapy,CAR-T(chimeric antigen receptor T cell),which is engineered to express a chimeric receptor to recognize the tumor antigen,can specifically eliminate tumor cells.CAR-T has attracted much attention due to its promising value in the treatment of a variety of hematological malignancies.However,more and more clinical studies have shown that CAR-T can cause a series of adverse events,affecting the prognoses of patients.This review aims to summarize the evolution of CAR construct design,the applications of CAR-T in acute lymphoblastic leukemia,acute myeloid leukemia,lymphoma and multiple myeloma and the related adverse events,and provide the discussion on how to improve the efficacy and safety of CAR-T therapy.