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NEJM：Kymriahc治疗儿童和青年复发或难治性B细胞急性淋巴细胞白血病

2018-02-01 zhangfan MedSci原创

儿童和青年复发或难治性B细胞急性淋巴细胞白血病KymriahcALL
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研究认为，接受单次Kymriahc治疗后，儿童和青年复发或难治性B细胞急性淋巴细胞白血病患者可产生持续性疾病缓解

在先前开展的单中心1-2a期临床研究中，抗CD 19嵌合抗原受体T细胞疗法对儿童和青年复发性或难治性B细胞急性淋巴细胞白血病(ALL)具有很高的完全缓解率，但存在可逆的毒性作用。

近日研究人员公布了儿童和青年CD 19+复发或难治性B细胞ALL患者II期临床研究的组织学研究结果。本次研究的主要终点是治疗3个月后缓解率。

75名患者接受Kymriahc单次治疗并参与有效性评估。总体上，治疗3个月后的缓解率为81%，所有应答患者微小疾病残留阴性。6个月的无事件生存以及总生存率分别为73%和90%，12个月为50%和76%。中位缓解时间未达到。Kymriahc治疗的持续效应可长达20个月。73%的患者出现3-4级不良事件。77%的患者发生细胞因子释放综合征，其中48%的患者接受了托珠单抗治疗；40%的患者发生神经功能事件，所有患者均接受维持治疗，无脑水肿报道。

研究认为，接受单次Kymriahc治疗后，儿童和青年复发或难治性B细胞急性淋巴细胞白血病患者可产生持续性疾病缓解。

原始出处：

Shannon L. Maude et al. Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia. N Engl J Med. February 1 2018.

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    2018-02-08 grace5700

    #Kymriah#

    0

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    2018-10-26 sunyl07

    #淋巴细胞白血病#

    0

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    2018-02-02 xiaoyeshuang

    #B细胞#

    0

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    2018-02-02 wetgdt

    #淋巴细胞#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2025295, encodeId=7b44202529555, content=<a href='/topic/show?id=e8b01060688' target=_blank style='color:#2F92EE;'>#Kymriah#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10606, encryptionId=e8b01060688, topicName=Kymriah)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Thu Feb 08 05:55:00 CST 2018, time=2018-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997878, encodeId=c991199e87810, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Fri Oct 26 07:55:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273223, encodeId=592e12e322319, content=<a href='/topic/show?id=310d383ef5' target=_blank style='color:#2F92EE;'>#B细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3837, encryptionId=310d383ef5, topicName=B细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302141, encodeId=20da130214167, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1477166, encodeId=fb6214e71667c, content=<a href='/topic/show?id=ef26384487' target=_blank style='color:#2F92EE;'>#B细胞急性淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3844, encryptionId=ef26384487, topicName=B细胞急性淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f3587357279, createdName=12498474m32暂无昵称, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528446, encodeId=c9a915284460a, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284133, encodeId=6edb2841332a, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Thu Feb 01 09:50:30 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284121, encodeId=760e284121f7, content=利妥昔单抗应用效果还是不错的, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/12/31/60fc0213ae09a3dbbba19993663ef4db.jpg, createdBy=33c31971480, createdName=1e160a78m83(暂无匿称), createdTime=Thu Feb 01 09:18:05 CST 2018, time=2018-02-01, status=1, ipAttribution=)]
    2018-02-02 12498474m32暂无昵称

    #B细胞急性淋巴细胞白血病#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2025295, encodeId=7b44202529555, content=<a href='/topic/show?id=e8b01060688' target=_blank style='color:#2F92EE;'>#Kymriah#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10606, encryptionId=e8b01060688, topicName=Kymriah)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Thu Feb 08 05:55:00 CST 2018, time=2018-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997878, encodeId=c991199e87810, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Fri Oct 26 07:55:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273223, encodeId=592e12e322319, content=<a href='/topic/show?id=310d383ef5' target=_blank style='color:#2F92EE;'>#B细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3837, encryptionId=310d383ef5, topicName=B细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302141, encodeId=20da130214167, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1477166, encodeId=fb6214e71667c, content=<a href='/topic/show?id=ef26384487' target=_blank style='color:#2F92EE;'>#B细胞急性淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3844, encryptionId=ef26384487, topicName=B细胞急性淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f3587357279, createdName=12498474m32暂无昵称, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528446, encodeId=c9a915284460a, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284133, encodeId=6edb2841332a, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Thu Feb 01 09:50:30 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284121, encodeId=760e284121f7, content=利妥昔单抗应用效果还是不错的, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/12/31/60fc0213ae09a3dbbba19993663ef4db.jpg, createdBy=33c31971480, createdName=1e160a78m83(暂无匿称), createdTime=Thu Feb 01 09:18:05 CST 2018, time=2018-02-01, status=1, ipAttribution=)]
    2018-02-02 freve

    #难治性#

    0

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    2018-02-01 戒馋，懒，贪

    谢谢分享学习了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2025295, encodeId=7b44202529555, content=<a href='/topic/show?id=e8b01060688' target=_blank style='color:#2F92EE;'>#Kymriah#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10606, encryptionId=e8b01060688, topicName=Kymriah)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Thu Feb 08 05:55:00 CST 2018, time=2018-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997878, encodeId=c991199e87810, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Fri Oct 26 07:55:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273223, encodeId=592e12e322319, content=<a href='/topic/show?id=310d383ef5' target=_blank style='color:#2F92EE;'>#B细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3837, encryptionId=310d383ef5, topicName=B细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302141, encodeId=20da130214167, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1477166, encodeId=fb6214e71667c, content=<a href='/topic/show?id=ef26384487' target=_blank style='color:#2F92EE;'>#B细胞急性淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3844, encryptionId=ef26384487, topicName=B细胞急性淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f3587357279, createdName=12498474m32暂无昵称, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528446, encodeId=c9a915284460a, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Feb 02 23:55:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284133, encodeId=6edb2841332a, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Thu Feb 01 09:50:30 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284121, encodeId=760e284121f7, content=利妥昔单抗应用效果还是不错的, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/12/31/60fc0213ae09a3dbbba19993663ef4db.jpg, createdBy=33c31971480, createdName=1e160a78m83(暂无匿称), createdTime=Thu Feb 01 09:18:05 CST 2018, time=2018-02-01, status=1, ipAttribution=)]
    2018-02-01 1e160a78m83(暂无匿称)

    利妥昔单抗应用效果还是不错的

    0