浏览全部资源
扫码关注微信
新药时代下如何为异基因造血干细胞移植赋能
Improvement of hematopoietic stem cell transplantation in the targeted therapy era
- 第三军医大学学报 2021年43卷第21期 页码：2271-2275
- 作者机构：
400037 重庆，陆军军医大学(第三军医大学)第二附属医院血液病医学中心，全军血液病中心，创伤、烧伤与复合伤国家重点实验室
- 作者简介：
[张曦，博士，主任医师、教授，博士研究生导师，长江学者特聘教授。担任中华医学会血液学分会常务委员，获中华医学科技一等奖1项，重庆市科技进步一等奖2项，国家发明专利16项，主持国家、省部级课题37项；现为JHO、Leukemia、《中华血液学杂志》等杂志编委和审稿专家；主要从事造血微环境与造血干细胞移植方面的研究。已被SCI收录论文70余篇。E-mail: zhangxxi@sina.com ZHANG Xi, E-mail: zhangxxi@sina.com
- 基金信息：国家自然科学基金国际(地区)合作与交流项目(82020108004);国家血液系统疾病临床医学研究中心2020年度开放课题重点项目(2020ZKZC02)
DOI：10.16016/j.1000-5404.202108154
中图分类号： R617;R733.7收稿：2021-08-23，
修回：2021-09-28，
纸质出版：2021-11-15
- 稿件说明：
移动端阅览
张曦, 黄瑞昊. 新药时代下如何为异基因造血干细胞移植赋能[J]. 第三军医大学学报, 2021,43(21):2271-2275.
Xi ZHANG, Ruihao HUANG. Improvement of hematopoietic stem cell transplantation in the targeted therapy era[J]. Journal of Third Military Medical University, 2021, 43(21): 2271-2275.
张曦, 黄瑞昊. 新药时代下如何为异基因造血干细胞移植赋能[J]. 第三军医大学学报, 2021,43(21):2271-2275. DOI： 10.16016/j.1000-5404.202108154.
Xi ZHANG, Ruihao HUANG. Improvement of hematopoietic stem cell transplantation in the targeted therapy era[J]. Journal of Third Military Medical University, 2021, 43(21): 2271-2275. DOI： 10.16016/j.1000-5404.202108154.
摘要
造血干细胞移植是治愈血液肿瘤的手段之一，异基因造血干细胞移植技术在我国发展迅速，形成了许多具有中国特色的移植方案和技术体系，尤其是单倍型造血干细胞移植的成熟运用，基本解决了供者来源受限的问题。表观遗传调控药物、靶向白血病关键通路及免疫细胞疗法的不断涌现，为血液肿瘤治疗提供了新选择，也为造血干细胞移植提供了新的赋能手段。本文对新药在异基因造血干细胞移植全程(移植前、中、后)的应用及相关临床新技术、新方案进行总结，认为靶向药物等新药与造血干细胞移植更加紧密地联合是进一步提高移植疗效、增加安全性的有效方法；将现有的造血干细胞移植技术与新药有机地整合出最佳方案，以进一步提升疗效并提高患者生存质量，是今后该领域研究须重点关注的问题。
Abstract
Hematopoietic stem cell transplantation (HSCT) is one of best ways to treat hematological malignancies. And
allogeneic HSCT has been developing rapidly in our country within recent decades
and accomplished many transplantation schemes and technological systems with Chinese characteristics. Especially
the mature application of haplo-identical HSCT promotes the transplantation into an era of "everyone has a donor". Nowadays
constantly emerged epigenetic regulators
pathway modulators of leukemia genesis and immune cell therapies have provided more options for physician and patients so far in HSCT. In this article
we summarize the application of new drugs in the whole process of allogeneic HSCT (before
during and after transplantation) and related new technologies and new schemes. We consider that the closer combination of new drugs such as targeted drugs and HSCT is an effective measure to further improve the efficacy and safety of allogeneic HSCT. We should organically integrate the existing technologies and new drugs into the best scheme in order to further enhance the efficacy and improve the quality of life of patients. This is a problem that must be focused on in this field in the future.
关键词
Keywords
references
SUGITA J. HLA-haploidentical stem cell transplantation using posttransplant cyclophosphamide[J]. Int J Hematol, 2019, 110(1): 30-38. DOI: 10.1007/s12185-019-02660-8.
GAGELMANN N, BACIGALUPO A, RAMBALDI A, et al . Haploidentical stem cell transplantation with posttransplant cyclophosphamide therapy vs other donor transplantations in adults with hematologic cancers: a systematic review and meta-analysis[J ] . JAMA Oncol, 2019, 5(12): 1739-1748. DOI: 10.1001/jamaoncol.2019.3541..
HUANG R, LI X, HE Y, et al . Recent advances in CAR-T cell engineering[J ] . J Hematol Oncol, 2020, 13(1): 86. DOI: 10.1186/s13045-020-00910-5.
CORTES J, KANTARJIAN H. Chronic myeloid leukemia: sequencing of TKI therapies[J]. Hematology, 2016, 2016(1): 164-169. DOI: 10.1182/asheducation-2016.1.164.
CZYZ A, NAGLER A. The role of measurable residual disease (MRD) in hematopoietic stem cell transplantation for hematological malignancies focusing on acute leukemia[J]. Int J Mol Sci, 2019, 20(21): 5362. DOI: 10.3390/ijms20215362.
PARK J H, RIVIÈRE I, GONEN M, et al . Long-term follow-up of CD19 CAR therapy in acute lymphoblastic leukemia[J ] . N Engl J Med, 2018, 378(5): 449-459. DOI: 10.1056/nejmoa1709919.
WEN S, NIU Z, XING L, et al . CAR-T bridging to allo-HSCT as a treatment strategy for relapsed adult acute B-lymphoblastic leukemia: a case report[J ] . BMC Cancer, 2018, 18(1): 1143. DOI: 10.1186/s12885-018-5037-7.
GOEBELER M E, BARGOU R C. T cell-engaging therapies-BiTEs and beyond[J]. Nat Rev Clin Oncol, 2020, 17(7): 418-434. DOI: 10.1038/s41571-020-0347-5.
FLOTHO C, SOMMER S, LVBBERT M. DNA-hypomethylating agents as epigenetic therapy before and after allogeneic hematopoietic stem cell transplantation in myelodysplastic syndromes and juvenile myelomonocytic leukemia[J]. Semin Cancer Biol, 2018, 51: 68-79. DOI: 10.1016/j.semcancer.2017.10.011.
郑慧菲, 王婧, 周进, 等. 地西他滨桥接异基因造血干细胞移植治疗骨髓增生异常综合征的疗效分析[J]. 中华血液学杂志, 2015, 36 (2): 121-124. DOI: 10.3760/cma.j.issn.0253-2727.2015.02.008.
ZHENG H F, WANG J, ZHOU J, et al . Retrospective efficacy analysis of decitabine bridging allogeneic hematopoietic stem cell transplantation on the treatment of myelodysplastic syndrome[J ] . Chin J Hematol, 2015, 36(2): 121-124. DOI: 10.3760/cma.j.issn.0253-2727.2015.02.008.
HUI Y, LI Y, TONG X W, et al . Reinduction chemotherapy regimen involved decitabine and cladribine improves the prognosis of patients with relapsed or refractory acute myeloid leukemia: a preliminary study[J ] . Int J Cancer, 2021: ijc. 33595. DOI: 10.1002/ijc.33595.
SPIERINGS E, KIM Y H, HENDRIKS M, et al . Multicenter analyses demonstrate significant clinical effects of minor histocompatibility antigens on GvHD and GvL after HLA-matched related and unrelated hematopoietic stem cell transplantation[J ] . Biol Blood Marrow Transplant, 2013, 19(8): 1244-1253. DOI: 10.1016/j.bbmt.2013.06.001.
CAO Y G, HE Y, ZHANG S D, et al . Conditioning regimen of 5-day decitabine administration for allogeneic stem cell transplantation in patients with myelodysplastic syndrome and myeloproliferative neoplasms[J ] . Biol Blood Marrow Transplant, 2020, 26(2): 285-291. . DOI: 10.1016/j.bbmt.2019.09.001
TANG X W, VALDEZ B C, MA Y J, et al . Low-dose decita bine as part of a modified Bu-Cy conditioning regimen improves survival in AML patients with active disease undergoing allogeneic hematopoietic stem cell transplantation[J ] . Bone Marrow Transplant, 2021, 56(7): 1674-1682. DOI: 10.1038/s41409-021-01238-5.
ZHANG C, CHEN X H, LIU J, et al . Decitabine as a conditioning regimen in haploidentical stem cell transplantation for refractory acute myeloid leukaemia[J ] . J Clin Pharm Ther, 2015, 40(3): 336-338. DOI: 10.1111/jcpt.12251.
SERVAIS S, BARON F, BEGUIN Y. Allogeneic hematopoietic stem cell transplantation (HSCT) after reduced intensity conditioning[J]. Transfus Apher Sci, 2011, 44(2): 205-210. DOI: 10.1016/j.transci.2011.01.019.
SANDMAIER B M, KORNBLIT B, STORER B E, et al . Addition of sirolimus to standard cyclosporine plus mycophenolate mofetil-based graft-versus-host disease prophylaxis for patients after unrelated non-myeloablative haemopoietic stem cell transplantation: a multicentre, randomised, phase 3 trial[J ] . Lancet Haematol, 2019, 6(8): e409-e418. DOI: 10.1016/S2352-3026(19)30088-2.
LI M M, LI C, GENG S X, et al . Decitabine with or without micro-transplantation for the treatment of intermediate or high-risk myelodysplastic syndrome: a Chinese single-center retrospective study of 22 pati ents[J ] . Front Oncol, 2021, 11: 628127. DOI: 10.3389/fonc.2021.628127.
ZHANG C, KONG P Y, LI S Q, et al . Donor-derived CAR-T cells serve as a reduced-intensity conditioning regimen for haploidentical stem cell transplantation in treatment of relapsed/refractory acute lymphoblastic leukemia: case report and review of the literature[J ] . J Immunother, 2018, 41(6): 306-311. DOI: 10.1097/cji.0000000000000233.
CHANG Y J, WU D P, LAI Y R, et al . Antithymocyte globulin for matched sibling donor transplantation in patients with hematologic malignancies: a multicenter, open-label, randomized controlled study[J ] . J Clin Oncol, 2020, 38(29): 3367-3376. DOI: 10.1200/jco.20.00150.
MO X D, XU L P, ZHANG X H, et al . Chronic GVHD induced GVL effect after unmanipulated haploidentical hematopoietic SCT for AML and myelodysplastic syndrome[J ] . Bone Marrow Transplant, 2015, 50(1): 127-133. DOI: 10.1038/bmt.2014.223.
MA Y J, QU C J, DAI H P, et al . Maintenance therapy with decitabine after allogeneic hematopoietic stem cell transplantation to prevent relapse of high-risk acute myeloid leukemia[J ] . Bone Marrow Transplant, 2020, 55(6): 1206-1208. DOI: 10.1038/s41409-019-0677-z.
GAO L, ZHANG Y Q, WANG S B, et al . Effect of rhG-CSF combined with decitabine prophylaxis on relapse of patients with high-risk MRD-negative AML after HSCT: an open-label, multicenter, randomized controlled trial[J ] . J Clin Oncol, 2020, 38(36): 4249-4259. DOI: 10.1200/jco.19.03277.
XUAN L, WANG Y, HUANG F, et al . Sorafenib maintenance in patients with FLT3-ITD acute myeloid leukaemia undergoing allogeneic haematopoietic stem-cell transplantation: an open-label, multicentre, randomised phase 3 trial[J ] . Lancet Oncol, 2020, 21(9): 1201-1212. DOI: 10.1016/S1470-2045(20)30455-1.
SAINI N, MARIN D, LEDESMA C, et al . Impact of TKIs post-allogeneic hematopoietic cell transplantation in Philadelphia chromosome-positive ALL[J ] . Blood, 2020, 136(15): 1786-1789. DOI: 10.1182/blood.2019004685.
ZHANG C, WANG X Q, ZHANG R L, et al . Donor-derived CD19 CAR-T cell therapy of relapse of CD19-positive B-ALL post allotransplant[J ] . Leukemia, 2021, 35(6): 1563-1570. DOI: 10.1038/s41375-020-01056-6.
GAO L, ZHANG Y Q, HU B Y, et al . Phase Ⅱ multicenter, randomized, double-blind controlled study of efficacy and safety of umbilical cord-derived mesenchymal stromal cells in the prophylaxis of chronic graft-versus-host disease after HLA-haploidentical stem-cell transplantation[J ] . J Clin Oncol, 2016, 34(24): 2843-2850.
0
浏览量
0
下载量
0
CSCD
- 网络PDF下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
