CLIN CANCER RES:Tisagenlecleucel治疗B细胞急性淋巴细胞白血病的临床药理学

2018-12-21 MedSci MedSci原创

Tisagenlecleucel是一种抗CD19嵌合抗原受体(CAR19)T细胞疗法,被批准用于治疗患有复发/难治性(r / r)B细胞急性淋巴细胞白血病(B-ALL)的儿童和年轻人。CLIN CANCER RES近期发表了一篇文章,研究Tisagenlecleucel的临床药理学。

Tisagenlecleucel是一种抗CD19嵌合抗原受体(CAR19)T细胞疗法,被批准用于治疗患有复发/难治性(r / r)B细胞急性淋巴细胞白血病(B-ALL)的儿童和年轻人。CLIN CANCER RES近期发表了一篇文章,研究Tisagenlecleucel的临床药理学。

作者评估了tisagenlecleucel的细胞动力学,患者、体液免疫原性等对其动力学的影响,在79例患者中分析其疗效,安全性和药效学终点。研究结果表明,有治疗反应的患者(N = 62)外周血中的tisagenlecleucel扩增比无治疗反应者高约2倍,在有治疗反应的患者中可检测的时间超过2年。Cmax随细胞因子释放综合征(CRS)的发生和严重程度增加。tocilizumab用于治疗CRS,使用tocilizumab后Tisagenlecleucel持续扩增。与出现持续治疗反应的患者相比,6个月内B细胞复发的患者转基因丢失的更早。所有剂量范围的患者均观察到临床反应,剂量与安全性无关。抗小鼠CAR19抗体并未影响临床反应或持久性。

文章最后认为,对tisagenlecleucel的治疗反应与扩增增加有关。这些结果表明细胞动力学在理解CART细胞疗法治疗反应的重要性。

原始出处:

Karen Thudium Mueller, Edward Waldron, et al. Clinical Pharmacology of Tisagenlecleucel in B-cell Acute Lymphoblastic Leukemia. CLIN CANCER RES. December 2018 doi: 10.1158/1078-0432.CCR-18-0758

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    2018-12-22 维他命

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可测量残留病(MRD)持续存在是急性淋巴细胞白血病(ALL)初始治疗后复发和生存的有力预测因子。本文主要针对应用MRD相关信息制定成人ALL患者治疗决策提供共识声明和循证框架。

CLIN CANCER RES :儿童急性淋巴细胞白血病患者神经毒性风险和预后的差异

甲氨蝶呤化疗与治疗期间神经系统并发症及长期神经功能损害有关。CLIN CANCER RES近期发表了一篇文章,研究与甲氨蝶呤神经毒性发生率相关的人口统计学和临床因素,并阐述了神经毒性对儿童急性淋巴细胞白血病(ALL)患者治疗的影响。

儿童急性淋巴细胞白血病诊疗规范(2018版)

为落实国家卫生健康委、国家发展改革委、人力资源社会保障部、国家医保局、国家中医药局、国家药监局联合印发的《关于开展儿童白血病救治管理工作的通知》要求,进一步提高儿童白血病诊疗规范化水平,保障医疗质量与安全,组织制定了儿童急性淋巴细胞白血病诊疗规范(2018年版)。

Blood:在ERG基因上发现急性淋巴细胞白血病的新的易感突变位点

中心点:在拉美裔人中进行GWAS发现ERG是ALL的新风险位点,其效应强弱与印第安人血统相关。ALL患者携带ETV6-RUNX1融合或体细胞ERG缺失时,ERG风险不明显,但在TCF3-PBX1亚型的ALL患者中表现为富集。摘要:急性淋巴细胞白血病(ALL)是儿童最常见的恶性肿瘤。拉美裔美国人具有较高的印第安人血统,ALL的发病率高,生存率低,但由于缺乏拉美裔美国人全基因组测序数据,对造成上述差异

Blood:如何治疗费城染色体阳性的急性淋巴细胞白血病?

靶向特定分子事件药物的引物改变了许多恶性肿瘤的治疗模式。既往我们完全是根据DNA相互作用的细胞毒性药物来治疗白血病患者。随着对白血病细胞生理和病理机制以及其逃逸免疫监测机制的方式的了解的加深,我们很有可能开发出更有效的药物,减少对化疗的依赖,从而完成深入根除疾病的目的。对于费城染色体阳性(Ph+)的急性淋巴细胞白血病(ALL),越来越强效的酪氨酸激酶抑制剂(TKIs)的引入彻底变革了治疗方法。这类