Progress in the study of CAR-T cell therapy in the treatment of hematological tumors of central nervous system
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摘要: 中枢神经系统(central nervous system，CNS)是血液系统恶性肿瘤常见的髓外侵犯部位，且往往与不良预后密切相关，然而现有疗法及疗效远不能满足需求。嵌合抗原受体T(CAR-T)细胞疗法在国内外血液肿瘤的治疗中已表现出较大优势，但由于其治疗不良反应存在神经毒性风险，使得治疗中枢系统血液肿瘤仍饱受争议。因此，文章针对国内外部分CAR-T疗法治疗中枢系统血液肿瘤的研究做一综述，探讨此疗法用于治疗中枢血液肿瘤的可能性、安全性及有效性，为临床工作提供参考，以期提高中枢系统血液肿瘤患者的缓解率与生存率。Abstract: The central nervous system(CNS) is a common site of extramedullary invasion by hematological malignant tumors, and the involvement of the CNS is often closely related to poor prognosis. However, the existing therapies and their curative effects are far from meeting the needs. CAR-T cell therapy has shown great advantages in the treatment of hematological tumors at home and abroad, but the treatment of CNS hematological tumors has been controversial due to the risk of neurotoxicity. Therefore, this article reviews some of the studies on CAR-T in the treatment of CNS hematological tumors, and discusses the possibility, safety and efficacy of the therapy in the treatment of CNS hematological tumors. The purpose is to provide a reference for clinical work and improve the remission rate and survival rate of such patients.
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表 1 CAR-T细胞治疗伴中枢系统侵犯血液肿瘤相关的临床试验
编号 CAR-T类型 人群 中枢受累例数/例 BM缓解率/% 中枢缓解率/% ≥3级CRS/% ≥3级NE/% NCT02782351 CD19/CD22 R/R B-ALL 48 87.5 85.4 18.8 22.9 NCT02445248 CD19、Tisa-cell PCNSL 12 50.0 42.9 0 8.3 NCT02153580 CD19 PCNSL 5 - 60.0 0 20.0 NCT04572308 CD7 R/R T-ALL/T-LBL 3 94.1 - 5 0 NCT04916860 CD7 R/R T-LBL 2 75.0 - 12.5 0 NCT03064269 ssCART-19s R/R B-ALL 3 - - 0 0 Pedi CART19、13BT022、ENSIGN、ELIANA、16CT022 CD19、Tisa-cell、huCART19 R/R B-ALL/LBL 66 - 97.0 25.6 11.8 
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