Kev Tshawb Fawb Txog Kev Kawm | Pab Pawg Kho Mob Lu Daopei Luam Tawm Kev Tshawb Fawb Txog Kev Kho Mob Tshiab hauv British Journal of Hematology

Hauv kev ua tiav tseem ceeb rau Lu Daopei Medical Team, ib daim ntawv tshawb fawb txog kev kho mob uas muaj npe hu ua "Kev tshawb fawb txog kev nyab xeeb thiab kev ua tau zoo ntawm kev hloov pauv hlwb allogeneic haematopoietic rau cov neeg mob uas tsis kho tau thiab rov qab mob T-cell acute lymphoblastic leukaemia/lymphoblastic lymphoma uas tau txais kev zam txim tag nrho tom qab autologous CD7 chimeric antigen receptor T-cell therapy" tau luam tawm hauv cov npe nrov British Journal of Hematology (IF = 5.1). Txoj kev tshawb fawb no, sau los ntawm Dr. Cao Xingyu nrog Prof. Lu Peihua ua tus sau ntawv sib xws, tsom mus rau lub peev xwm zoo ntawm kev txuas allo-HSCT rau cov neeg mob R/R T-ALL thiab T-LBL uas tau txais kev zam txim tag nrho (CR) tom qab kev kho mob CD7 CAR-T autologous.

Keeb Kwm Kev Tshawb Fawb:

Cov kab mob T-cell malignancies, xws li T-ALL thiab T-LBL, paub txog lawv qhov kev ua phem thiab kev tiv thaiv kev kho mob siab. Rau cov neeg mob uas tsis kho tau lossis rov qab mob T-ALL/LBL (R/R T-ALL/T-LBL), cov kev kho mob ib txwm muaj kev vam meej tsawg thiab kev kwv yees tsis zoo. Txawm li cas los xij, CD7 CAR-T kev kho mob tau tshwm sim los ua qhov kev tshawb pom tshiab, qhia txog kev cog lus tseem ceeb hauv kev kho cov mob nyuaj kho no, txawm tias tseem nyob rau theem pib ntawm kev sim tshuaj. Thaum ua raws li kev sib koom ua ke nrog allo-HSCT, cov neeg mob uas ua tiav CR nrog CD7 CAR-T kev kho mob tau muab lub sijhawm tiag tiag ntawm kev zam txim mus sij hawm ntev.

Txoj Kev Kawm:

Daim kev tshawb fawb rov qab no tau tshuaj xyuas cov neeg mob R/R T-ALL thiab T-LBL uas tau txais kev kho mob NS7 CAR-T, ua raws li kev sib sau ua ke ntawm allo-HSCT ntawm lub Kaum Ib Hlis 2020 thiab Lub Ib Hlis 2023 ntawm Tsev Kho Mob Lu Daopei. Daim kev tshawb fawb tau tshuaj xyuas ntau yam, suav nrog hnub nyoog ntawm tus neeg mob, tus lej theej ntawm CAR-T cell ua ntej hloov pauv, thiab cov txheej txheem CAR-T sib txawv, los ntsuas lawv qhov cuam tshuam rau cov txiaj ntsig hloov pauv. Cov txiaj ntsig tau piv rau cov ntawm 124 tus neeg mob uas tau txais CR los ntawm kev kho mob chemotherapy ua raws li allo-HSCT.

Cov Ntsiab Lus Tseem Ceeb:

Cov kev tshawb fawb no suav nrog 34 tus neeg mob R/R T-ALL/T-LBL uas tau txais CR tom qab NS7 CAR-T kev kho mob thiab tom qab ntawd tau txais allo-HSCT. Lub sijhawm nruab nrab ntawm CAR-T kev kho mob thiab kev hloov pauv yog 57.5 hnub. Qhov tseem ceeb, 47.1% ntawm cov neeg mob muaj tus kab mob refractory thawj zaug, thaum 52.9% tau rov qab mob dua. Tom qab CAR-T infusion, cytokine release syndrome (CRS) tau tshwm sim hauv 33 tus neeg mob, nrog rau 94.1% muaj Qib 1-2 CRS. Hmoov zoo, tsis muaj cov neeg mob tau tsim tus kab mob immune effector cell-associated neurotoxicity syndrome (ICANS).

Tom qab 28 hnub tom qab CAR-T, muaj 31 tus neeg mob tau txais MRD-negative CR, thaum muaj 3 tus neeg mob muaj MRD-positive CR. Kev tshawb fawb kuj pom tias cov neeg mob uas muaj ≤20% ntawm cov pob txha tawg ua ntej hloov pauv muaj 0% tus nqi rov qab los ntawm 18 lub hlis tom qab hloov pauv. Thaum piv rau cov neeg mob CR uas siv tshuaj kho mob chemotherapy, tus nqi ciaj sia nyob 2 xyoos (OS) zoo sib xws: 61.9% rau pawg CD7 CAR-T vs. 67.6% rau pawg chemotherapy. Tsis tas li ntawd, tus nqi ciaj sia nyob 2 xyoos uas tsis muaj leukemia (LFS) zoo sib xws (62.3% vs. 62.0%).

Tshwj xeeb tshaj yog, cov neeg mob hnub nyoog ≤14 xyoo uas tau txais kev kho mob CD7 CAR-T muaj 87.5% 2-xyoo OS thiab LFS zoo heev. Cov txiaj ntsig qhia tau tias kev kho mob CD7 CAR-T ua raws li allo-HSCT tuaj yeem muab lwm txoj hauv kev nyab xeeb thiab zoo rau cov neeg mob R / R T-ALL / T-LBL uas tsis tsim nyog rau kev kho mob ib txwm muaj.

Xaus lus:

Cov kev tshawb fawb xaus lus tias kev sib xyaw ua ke ntawm CD7 CAR-T kev kho mob ua raws li allo-HSCT muab kev kho mob zoo thiab zoo rau cov neeg mob R/R T-ALL/T-LBL. Cov txiaj ntsig zoo ib yam li cov uas tau ua tiav nrog chemotherapy thiab allo-HSCT, tsis muaj kev nce ntxiv ntawm kev tuag tsis rov qab los, muab kev xaiv kho mob tseem ceeb rau cov neeg mob uas muaj kev xaiv kho mob tsawg. Cov kev tshawb pom ntawm kev tshawb fawb muab kev cia siab rau kev zam txim mus sij hawm ntev thiab kev ciaj sia, tshwj xeeb tshaj yog rau cov neeg mob uas muaj kev pheej hmoo siab uas tau txais kev sib koom ua ke nrog allo-HSCT raws sijhawm.

Kev Cuam Tshuam thiab Kev Pom Yav Tom Ntej:

Kev tshaj tawm txoj kev tshawb fawb tshiab no hauv British Journal of Hematologyyog ib qho pov thawj rau kev mob siab thiab kev txawj ntse ntawm Lu Daopei Medical Team. Qhov kev ua tiav no qhia txog lub tsev kho mob txoj kev siv zog hauv kev txhim kho kev kho mob ntshav thiab lawv cov kev pabcuam tseem ceeb rau lub zej zog kho mob thoob ntiaj teb. Nws qhia txog lub peev xwm ntawm CD7 CAR-T kev kho mob ua ib qho kev xaiv zoo rau cov neeg mob uas muaj R / R T-ALL / T-LBL thiab qhia txog pab pawg neeg txoj kev cog lus los thawb cov ciam teb ntawm hematological Kev Kho Mob Cancer.