成人急性淋巴细胞白血病(ALL)化疗后复发率仍然很高。通过更好的分子诊断和分类以及对微小残留病的更好评估,难治性和/或复发性ALL的治疗正在取得重大进展。除了用于费城染色体阳性ALL的酪氨酸激酶抑制剂(TKIs),免疫治疗剂,blinatumomab,伊托珠单抗奥佐大霉素(INO),和嵌合抗原受体(CAR)T细胞,正在改变所有人的治疗模式。Blinatumomab和INO被纳入诱导化疗方案,并与TKIs联合用于ALL治疗。一种新的低强度方案,miniHCVD-INO-blinatumomab,似乎比传统的强化化疗方案毒性更小,更有效。本文综述了ALL治疗的新研究以及双特异性抗体临床试验的最新进展。抗体-药物缀合物,以及掺入这些新型抗体的新疗法。
The relapse rate remains high after chemotherapy for adult patients with acute lymphoblastic leukemia (ALL). With better molecular diagnosis and classification as well as better assessment for minimal residual disease, major progress in the treatment for refractory and/or relapsed ALL is being made. In addition to the tyrosine kinase inhibitors (TKIs) for Philadelphia chromosome-positive ALL, immunotherapeutic agents, blinatumomab, inotuzumab ozogamicin (INO), and chimeric antigen receptor (CAR) T cells, are changing the treatment paradigm for ALL. Blinatumomab and INO are being incorporated into induction chemotherapy regimens and combined with TKIs for ALL therapy. A novel low-intensity regimen, miniHCVD-INO-blinatumomab, appears to be less toxic and more effective than conventional intensive chemotherapy regimens. This review summarized new therapeutic researches of ALL and updated latest progress in clinical trials on bispecific antibodies, antibody-drug conjugates, and new regimens incorporating these novel antibodies.