首页|血液肿瘤微环境对CAR-T免疫疗法疗效及其不良反应的影响的研究进展

血液肿瘤微环境对CAR-T免疫疗法疗效及其不良反应的影响的研究进展

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嵌合抗原受体T细胞(CAR-T)免疫疗法的应用开创了肿瘤治疗的新时代,特别是在多种难治性恶性肿瘤的治疗中取得空前成功,对于难治/复发血液系统恶性肿瘤如急性白血病、淋巴瘤、多发性骨髓瘤(MM)等更是效果显著.肿瘤微环境(TME)与CAR-T疗法的疗效及不良反应关系密切,不仅影响CAR-T细胞的活性,降低其抗肿瘤能力,甚至直接参与CAR-T疗法相关不良反应如细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS)的发生发展.因此,深入了解血液TME在CAR-T疗法治疗过程及不良反应中的作用,有助于拓展CAR-T疗法在血液系统恶性肿瘤中的应用.本文主要围绕血液TME对CAR-T疗法疗效和不良反应的影响进行综述,期望为临床优化难治/复发性血液系统恶性肿瘤的治疗方案提供循证依据.
Research Progress on the Influence of Blood Tumor Microen-vironment on the Efficacy and the Adverse Reactions of CAR-T Cell Immunotherapy——Review
The application of chimeric antigen receptor T cell(CAR-T)immunotherapy has ushered in a new era in cancer therapy,especially in the treatment of many kinds of refractory malignant tumors.The curative effect is significant for refractory/recurrent hematologic malignancies,such as acute leukemia,lymphoma,and multiple myeloma(MM).Tumor microenvironment(TME)is closely related to the efficacy and adverse reactions of CAR-T therapy.TME not only affects the activity of CAR-T cells,reduces their anti-tumor ability,but also directly involved in the occurrence and development of CAR-T cell therapy-related adverse reactions,such as cytokine release syndrome(CRS)and immune effector cell-associated neurotoxicity syndrome(ICANS).Therefore,a deeper understanding of the role of blood TME in the process of CAR-T immunotherapy and the occurrence and development of adverse reactions is helpful for the application of CAR-T therapy in hematological malignancies.In this review,the influence of blood TME on the efficacy and adverse reactions of CAR-T immunotherapy was briefly summarized,aiming to provide evidence-based support for the clinical optimization of therapeutic regimen of refractory/recurrent hematologic malignancies.

tumor microenvironmentchimeric antigen receptor T cellsimmunotherapyhematologic malignancies

廖彩凤、赖胡榕、李剑

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南昌大学第二附属医院血液科、血液重点实验室

南昌大学医学部,江西南昌 330006

肿瘤微环境 嵌合抗原受体T细胞 免疫疗法 血液系统恶性肿瘤

2024

中国实验血液学杂志
中国病理生理学会

中国实验血液学杂志

CSTPCD北大核心
影响因子:0.988
ISSN:1009-2137
年,卷(期):2024.32(4)
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