T系白血病的CAR-T治疗:进展、困境和未来出路

CAR-T Therapy for T-lineage Leukemia:Progress,Dilemmas,and Way Forward

免疫治疗在血液恶性肿瘤治疗领域有着举足轻重的地位,而其中嵌合抗原受体(CAR)T细胞疗法为血液恶性肿瘤免疫治疗构建了新的治疗格局,在B系血液恶性肿瘤治疗领域收获了较为满意的临床效果。而由于存在CAR-T细胞自相残杀、肿瘤细胞污染、持续性T细胞缺乏等临床相关问题,CAR-T细胞疗法在治疗急性T淋巴细胞白血病(T-ALL)时受到一定限制。因此,突破现有瓶颈,对T-ALL的CAR-T疗法进行优化,提高疗效的同时改善患者的预后,是当前的主要任务。

Tumor immunotherapy occupies a pivotal position in the field of hematological malignancies.Chimeric antigen receptor(CAR)T-cell therapy has established a new therapeutic pattern for hematological immunotherapy and achieved satisfactory clinical results in the treatment of B-lineage hematological malignancies.However,CAR T-cell therapy has some limitations in the treatment of T-cell acute lymphoblastic leukemia because of the presence of CAR T-cell fratricide,tumor cell contamination,T-cell aplasia,and other clinically relevant problems.Therefore,the current major challenge is overcoming the existing bottlenecks to optimize CAR-T therapy and improve its efficacy against T-ALL while improving the prognosis of patients.