JCO：Ibrutinib治疗慢性淋巴细胞白血病后失败怎么办？抗CD19抗体提供新思路

2017-07-19 xuyihan MedSci原创

近日在JCO上发表的一篇文章评估了抗-CD19嵌合抗体受体—修饰T（CAR-T）细胞治疗用于先前接受过ibrutinib的慢性淋巴细胞白血病（CLL）患者的安全性和可行性。

近日在JCO上发表的一篇文章评估了抗-CD19嵌合抗体受体—修饰T（CAR-T）细胞治疗用于先前接受ibrutinib的慢性淋巴细胞白血病（CLL）患者的安全性和可行性。

24例CLL患者接受了淋巴细胞化疗和抗-CD19 CAR-T治疗，分为3个剂量水平（2 × 10⁵, 2 × 10⁶ or 2 × 10⁷CAR-T cells/kg）。19例患者在接受ibrutinib治疗时出现疾病进展，3例患者ibrutinib不耐受，还有2例患者接受ibrutinib治疗时未发生疾病进展。6例患者venetoclax难治，23例有复杂染色体核型和/或17p缺失。

CAR-T细胞灌注后4周，由国际研讨会对慢性淋巴细胞白血病（IWCLL）标准确定的总体反应率（完全反应（CR）和/或部分反应（PR））为71%（17/24）。20例（83%）患者出现了细胞因子释放综合征，8例（33%）患者出现神经毒性，虽然是可逆的但是1例患者出现致命结果。24例中20例接受环磷酰胺和氟达拉滨化疗和CD19 CAR-T细胞达到或者低于最大耐受量(≤2×10⁶CAR-T cells/kg)。

前文所指19例患者，IWCLL确认静脉注射后4周的总体反应率为74%（CR，4/19，21%;PR，10/19，53%）。17例在CAR-T治疗前出现骨髓疾病的患者中有15例（88%）在治疗后流式细胞仪显示没有病灶，其中12例患者接受了深度IGH测序，7例（58%）骨髓检查未及恶性IGH测序，而这些患者中在CAR-T细胞免疫治疗后经IWCLL确认无进展生存期和总体生存期为100%（中位随访时间为6.6个月）。

由此可见，CD19 CAR-T细胞治疗对于接受ibrutinib治疗失败后的高危CLL患者疗效显著。

原始出处：

Cameron J. Turtle.et al. Durable Molecular Remissions in Chronic Lymphocytic Leukemia Treated With CD19-Specific Chimeric Antigen Receptor–Modified T Cells After Failure of Ibrutinib.J CLIN ONCOL.2017.

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2017-09-06 晓辰

#新思路#

27 0
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2018-04-20 sunyl07

#淋巴细胞白血病#

23 0
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2017-12-08 lidong40

#JCO#

24 0
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2017-07-21 wetgdt

#淋巴细胞#

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2017-07-21 dingxiaobo

#CD19#

28 0
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2017-07-21 xsm924

#ibrutinib#

35 0

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JCO：Ibrutinib治疗慢性淋巴细胞白血病后失败怎么办？抗CD19抗体提供新思路

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