Combination of tyrosine kinase inhibitor(TKI)and standard chemotherapy has greatly improved the prognosis of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia(Ph+-ALL).Three-year overall survival(OS)rate of Ph+-ALL patients treated with chemotherapy combined with first-generation or second-generation TKI was approximately 40%-60%,and 6-year OS approached 75%when combined with the third-generation TKI ponatinib.However,2-year OS of patients with relapsed/refractory Ph+-ALL(R/R Ph+-ALL)was only 20%with a salvage therapy,indicating new treatment strategies are on demand,such as immunotherapy.Immunotherapies mainly utilize targeted antibodies including blinatumomab(anti-CD3 and CD19 bispecific antibodies),inotuzumab-ozogamicin(anti-CD22 monoclonal antibodies),and chimeric antigen receptor T-cell(CAR-T)therapy targeted antigen CD19.However,due to the limited improvement in long-term outcome from immunotherapy,a bridged allogeneic hematopoietic stem cell transplantation(allo-HSCT)was generally recommended after immunotherapy with complete remission.At present,some studies have shown that allo-HSCT was able to reduce relapse rate in Ph+-ALL,however,the improvement of overall survival produced by allo-HSCT after immunotherapy presented a controversial opinion nowadays.So further exploration of a bridged allo-HSCT post immunotherapy for R/R Ph+-ALL will be needed.This review mainly discussed the significant progress of immunotherapy in adult patients with relapsed/refractory Ph+-ALL in recent years,hoping to improve the remission rate and prognosis of patients with relapsed/refractory Ph+-ALL.
关键词
费城染色体急性淋巴细胞白血病/免疫治疗/异基因造血干细胞移植
Key words
Philadelphia chromosome-positive acute lymphoblastic leukemia/Immunotherapy/Allogeneic hematopoietic stem cell transplantation
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