摘要
急性B淋巴细胞白血病(B-cell acute lymphoblastic leukemia,B-ALL)是一种恶性血液病。研究发现,以CD19作为治疗靶点的贝林妥欧单抗(blinatumomab)作为异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)的桥梁显著改善了复发/难治性急性B淋巴细胞白血病(relapsed/refractory acute lymphoblastic leukemia,R/R B-ALL)患者的预后,其在新诊断急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)中与细胞毒性化疗药物或其他免疫治疗药物联用,在确保疗效的同时降低了方案的不良反应,在费城染色体阳性(Philadelphia chromosome-positive,Ph+)ALL患者中与二代/三代酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)联合应用,有望使患者后期无需移植治疗。此外,治疗后微小残留病变(minimal residual disease,MRD)对患者的复发和长期生存(overall survival,OS)具有显著影响,blinatumomab可提高ALL患者的MRD转阴率,保障了患者的远期预后。本综述重点介绍blinatumomab在B-ALL不同患者群体中的临床研究及相关进展。
B-cell acute lymphoblastic leukemia(ALL)is a hematological malignancy.Blinatumomab,as a therapeutic target,targeting CD19,has demonstrated notable efficacy as a safe bridge to allogeneic hematopoietic stem cell transplantation(allo-HSCT)in patients with relapsed/refractory acute lymphoblastic leukemia(R/R B-ALL).In the treatment of newly diagnosed ALL,blinatumomab,when combined with chemotherapy or other immunotherapies,reduces toxicity while ensuring efficacy.Similarly,combining blinatumomab with second-or thirdgeneration tyrosine kinase inhibitors(TKIs)for the treatment of Philadelphia chromosome--positive(Ph+)ALL holds promise for eliminating the need for subsequent allo-HSCT in patients.Disease relapse and long-term survival of patients are closely related to minimal residual disease(MRD)at the conclusion of treatment,and blinatumomab contributes to enhancing the MRD conversion rate in patients with ALL,thus improving the long-term prognosis.This article comprehensively reviews the clinical trials and current progress of blinatumomab in various BALL patient groups.
作者
李雪源
郭文璟(综述)
冯四洲(审校)
Xueyuan Li;Wenjing Guo;Sizhou Feng(Tianjin Medical University,Tianjin 300070,China;Haihe Laboratory of Cell Ecosystem,Tianjin 300020,China;Chinese Academy of Medical Sciences&Peking Union Medical College,Institute of Hematology&Blood Diseases Hospital,State Key Laboratory of Experimental Hematology,National Clinical Research Center for Blood Diseases,Tianjin 300020,China)
出处
《中国肿瘤临床》
CSCD
北大核心
2023年第22期1159-1163,共5页
Chinese Journal of Clinical Oncology
基金
细胞生态海河实验室创新基金项目(编号:22HHXBSS00036)资助。