Lancet Haematol:联合输注人源化抗CD19和抗BCMA CAR T细胞或是治疗复发或难治性多发性骨髓瘤的一种新疗法

2021-05-10 MedSci原创 MedSci原创

抗B细胞成熟抗原(BCMA)嵌合抗原受体(CAR)T细胞疗法已被证明对复发或难治性多发性骨髓瘤患者具有活性。有报告表明,一小部分分化程度较低的骨髓瘤克隆表达CD19,而抗CD19的CAR T细胞疗法对

抗B细胞成熟抗原(BCMA)嵌合抗原受体(CAR)T细胞疗法已被证明对复发或难治性多发性骨髓瘤患者具有活性。有报告表明,一小部分分化程度较低的骨髓瘤克隆表达CD19,而抗CD19的CAR T细胞疗法对其中一些患者显示出活性。来自中国徐州医科大学附属医院的研究人员进行了一项单中心、单臂、2期临床试验,旨在评估人源化抗CD19和抗BCMA CAR T细胞组合在复发或难治性多发性骨髓瘤患者中的活性和安全性,研究结果已发表于Lancet Haematol。

研究纳入18-69岁之间的多发性骨髓瘤患者,卡诺夫斯基表现评分在50分以上,并符合国际骨髓瘤工作组对复发或难治性疾病的诊断标准。在输注人源化抗CD19 CAR T细胞(每公斤1×106个细胞)和鼠源化抗BCMA CAR T细胞(每公斤1×106个细胞)之前,使用氟达拉滨(每天三次,每次30mg/m2)和环磷酰胺(每天一次,每次750mg/m2)来消耗淋巴细胞。主要结果是获得总缓解的患者比例。

 

2017年5月1日到2019年1月20日,研究共纳入22名患者,21名患者接受了CAR T细胞的输注,并可进行安全性和活性分析评估。中位随访179天(IQR 72-295),治疗总缓解率达到了95%(20/21),包括9名(43%)严格的完全缓解,3名(14%)完全缓解,5名(24%)非常好的部分缓解,以及3名(14%)部分缓解。最常见的不良事件包括细胞因子释放综合征(19/21,90%),包括18名患者(86%)出现1-2级细胞因子释放综合征。最常见的严重不良事件是血液学毒性,95%(20/21)的患者发生了这种情况。常见的3级或以上不良事件包括中性粒细胞减少(18[86%])、贫血(13[62%])和血小板减少(13[62%])。一名患者因脑出血而死亡,被认为与持续的血小板减少有关。没有发生与治疗有关的死亡。

综上所述,该研究结果证实,联合输注人源化抗CD19和抗BCMA CAR T细胞在复发或难治性多发性骨髓瘤患者中是可行的,研究所观察到的初步活性值得在随机试验中进一步研究。这种双重CAR-T细胞组合可能是复发或难治性多发性骨髓瘤的一种有希望的治疗选择。

 

原始出处:

 

Zhiling Yan, et al., A combination of humanised anti-CD19 and anti-BCMA CAR T cells in patients with relapsed or refractory multiple myeloma: a single-arm, phase 2 trial. Lancet Haematol. 2019 Oct;6(10):e521-e529. doi: 10.1016/S2352-3026(19)30115-2. 

 

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    2021-11-22 FukaiBao
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    2021-06-08 changfy
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-12-10 howi
  4. 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createdName=changfy, createdTime=Tue Jun 08 01:00:50 CST 2021, time=2021-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831153, encodeId=d5861831153af, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Dec 10 15:00:50 CST 2021, time=2021-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890247, encodeId=8682189024e25, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Mon Jul 05 19:00:50 CST 2021, time=2021-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317632, encodeId=9707131e632af, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416469, encodeId=e0221416469fd, content=<a href='/topic/show?id=924442e98f' target=_blank style='color:#2F92EE;'>#CD19#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4279, encryptionId=924442e98f, topicName=CD19)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f1583186918, createdName=dingxiaobo, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1460238, encodeId=785e1460238b2, content=<a href='/topic/show?id=833732e80d' target=_blank style='color:#2F92EE;'>#BCMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3278, encryptionId=833732e80d, topicName=BCMA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85f46265562, createdName=yykkxiaodou, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528751, encodeId=6b3a1528e5159, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554599, encodeId=98ee15545998d, content=<a href='/topic/show?id=74e458559f5' target=_blank style='color:#2F92EE;'>#新疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58559, encryptionId=74e458559f5, topicName=新疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d03114536414, createdName=kcb074, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-07-05 jml2009
  5. [GetPortalCommentsPageByObjectIdResponse(id=1969479, encodeId=dc0e19694e994, content=<a href='/topic/show?id=16675504ec5' target=_blank style='color:#2F92EE;'>#抗BCMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55047, encryptionId=16675504ec5, topicName=抗BCMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Mon Nov 22 18:00:50 CST 2021, time=2021-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008507, encodeId=d07e200850e8f, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, 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encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Mon Jul 05 19:00:50 CST 2021, time=2021-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317632, encodeId=9707131e632af, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416469, encodeId=e0221416469fd, content=<a href='/topic/show?id=924442e98f' target=_blank style='color:#2F92EE;'>#CD19#</a>, beContent=null, objectType=article, channel=null, 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href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554599, encodeId=98ee15545998d, content=<a href='/topic/show?id=74e458559f5' target=_blank style='color:#2F92EE;'>#新疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58559, encryptionId=74e458559f5, topicName=新疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d03114536414, createdName=kcb074, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-12 fengyi812
  6. [GetPortalCommentsPageByObjectIdResponse(id=1969479, encodeId=dc0e19694e994, content=<a href='/topic/show?id=16675504ec5' target=_blank style='color:#2F92EE;'>#抗BCMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55047, encryptionId=16675504ec5, topicName=抗BCMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Mon Nov 22 18:00:50 CST 2021, time=2021-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008507, encodeId=d07e200850e8f, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, 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href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554599, encodeId=98ee15545998d, content=<a href='/topic/show?id=74e458559f5' target=_blank style='color:#2F92EE;'>#新疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58559, encryptionId=74e458559f5, topicName=新疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d03114536414, createdName=kcb074, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-12 dingxiaobo
  7. 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href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554599, encodeId=98ee15545998d, content=<a href='/topic/show?id=74e458559f5' target=_blank style='color:#2F92EE;'>#新疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58559, encryptionId=74e458559f5, topicName=新疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d03114536414, createdName=kcb074, createdTime=Wed May 12 04:00:50 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-12 yykkxiaodou
  8. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-12 freve
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-12 kcb074
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034302, encodeId=0e8a1034302ce, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon May 10 16:00:50 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-10 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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