复发/难治性弥漫大B细胞淋巴瘤CAR-T细胞治疗进展
Advances in CAR-T Cell Therapy for Relapsed/Refractory Diffuse Large B-Cell Lymphoma
摘要: 弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma, DLBCL)是最常见的非霍奇金淋巴瘤(NHL)亚型，其具有高度异质性和侵袭性，DLBCL患者在临床特征、形态学、免疫组化、分子遗传学等方面存在显著异质性。尽管许多患者应用R-CHOP (利妥昔单抗 + 环磷酰胺 + 阿霉素 + 长春新碱 + 泼尼松)方案一线治疗后达到完全缓解(CR)，但仍有部分患者之后发展为复发和难治性的DLBCL，而一旦发展为复发难治性的DLBCL，常规的放疗和化疗则收效甚微。近年来，免疫治疗逐渐成为研究热点，嵌合抗原受体T (CAR-T)细胞治疗被认为是复发或难治性肿瘤的有效解决方案，特别是血液系统恶性肿瘤。嵌合抗原受体CAR-T细胞疗法已经彻底改变了恶性血液病的治疗。大约一半的难治性大B细胞淋巴瘤患者通过CD19靶向CAR-T治疗获得持久缓解；然而，只有一小部分情况下可以确定失效机制。本文现就复发/难治性弥漫大B细胞淋巴瘤CAR-T细胞治疗进展进行综述。
Abstract: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin’s lymphoma (NHL), which is highly heterogeneous and aggressive. DLBCL patients have significant heterogeneity in clinical features, morphology, immunohistochemistry and molecular genetics. Although many patients achieve complete remission (CR) after first-line treatment with R-CHOP (rituximab + cy-clophosphamide + adriamycin + vincristine + prednisone) regimen, some patients later develop re-lapsed and refractory DLBCL, and conventional radiotherapy and chemotherapy have little effect once they develop relapsed refractory DLBCL. In recent years, immunotherapy has become a hot research topic, and chimeric antigen receptor T (CAR-T) cell therapy is considered an effective solu-tion for relapsed or refractory tumors, especially hematologic malignancies. Chimeric antigen re-ceptor CAR-T cell therapy has revolutionized the treatment of malignant hematologic diseases. Ap-proximately half of patients with refractory large B-cell lymphoma achieve durable remission with CD19-targeted CAR-T therapy; however, mechanisms of failure can be identified in only a small percentage of cases. This article now reviews the progress of CAR-T cell therapy for re-lapsed/refractory diffuse large B-cell lymphoma.
文章引用：乔万芬, 罗伟. 复发/难治性弥漫大B细胞淋巴瘤CAR-T细胞治疗进展[J]. 临床医学进展, 2023, 13(5): 8386-8391. https://doi.org/10.12677/ACM.2023.1351173

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