Mechanisms of Relapse After CD19 CAR T-Cell Therapy for Acute Lymphoblastic Leukemia and Its Prevention and Treatment Strategies

被引：207
|
作者：
Xu, Xinjie [1 ,2 ]
Sun, Qihang [1 ,2 ]
Liang, Xiaoqian [1 ,2 ]
Chen, Zitong [1 ,2 ]
Zhang, Xiaoli [1 ,2 ]
Zhou, Xuan [1 ]
Li, Meifang [1 ]
Tu, Huilin [1 ,2 ]
Liu, Yu [1 ,2 ]
Tu, Sanfang [1 ]
Li, Yuhua [1 ]
机构：
[1] Southern Med Univ, Zhujiang Hosp, Dept Hematol, Guangzhou, Guangdong, Peoples R China
[2] Southern Med Univ, Sch Clin Med 2, Guangzhou, Guangdong, Peoples R China
来源：
FRONTIERS IN IMMUNOLOGY | 2019年 / 10卷
关键词：
CD19 CAR T-cell; relapse; mechanisms; prevention; treatment; strategies; CHIMERIC ANTIGEN RECEPTORS; CHONDROITIN SULFATE PROTEOGLYCAN; B-CELL; HUMAN HOMOLOG; INHIBITORY RECEPTORS; IMMUNE ESCAPE; RAT NG2; IMMUNOTHERAPY; ABNORMALITIES; PERSISTENCE;
D O I：
10.3389/fimmu.2019.02664
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Chimeric antigen receptor (CAR) T-cell therapy is highly effective in the treatment of B-cell acute lymphoblastic leukemia (ALL) or B-cell lymphoma, providing alternative therapeutic options for patients who failed to respond to conventional treatment or relapse. Moreover, it can bridge other therapeutic strategies and greatly improve patient prognosis, with broad applicable prospects. Even so, 30-60% patients relapse after treatment, probably due to persistence of CAR T-cells and escape or downregulation of CD19 antigen, which is a great challenge for disease control. Therefore, understanding the mechanisms that underlie post-CAR relapse and establishing corresponding prevention and treatment strategies is important. Herein, we discuss post-CAR relapse from the aspects of CD19-positive and CD19-negative and provide some reasonable prevention and treatment strategies.
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页数：15
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