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中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (2): 223-229.doi: 10.3969/j.issn.1674-5671.2025.02.14

• 综述 • 上一篇    下一篇

血液系统恶性肿瘤通用型CAR⁃T细胞治疗进展:GvHD/HvG 应对策略

  

  1. 首都医科大学附属北京同仁医院血液科
  • 出版日期:2025-04-25 发布日期:2025-05-15
  • 通讯作者: 王亮 E-mail:wangliangtrhos@126.com
  • 基金资助:
    国家自然科学基金资助项目(82370188;82170181)

Advances in universal CAR-T cell therapy for hematologic malignancies: strategies to overcome GvHD/HvG

  • Online:2025-04-25 Published:2025-05-15

摘要: 嵌合抗原受体(chimeric antigen receptor,CAR)⁃T细胞疗法在血液系统恶性肿瘤治疗中取得了显著成效,但目前获批的CAR⁃T产品多为自体CAR⁃T,存在制备周期长、成本高、产品质量不均等问题,限制了其广泛临床应用。通用型CAR⁃T(universal CAR⁃T,UCAR⁃T)疗法基于健康供体的T细胞,通过体外修饰和扩增,制备成“现货型”产品,能够实现“即用型”治疗模式,解决了自体CAR⁃T的诸多局限。然而,UCAR⁃T的应用仍面临移植物抗宿主病(graft⁃versus⁃host disease,GvHD)和宿主抗移植物反应(host⁃versus⁃graft reaction,HvG)等并发症的挑战。本文将综述UCAR⁃T疗法通过基因编辑技术、非基因编辑技术及选择合适的细胞源等策略规避GvHD和HvG的研究进展。

关键词: 血液系统恶性肿瘤, CAR?T细胞疗法, 通用型CAR?T细胞治疗, 移植物抗宿主病, 宿主抗移植物反应

Abstract: Chimeric antigen receptor (CAR)⁃T cell therapy has demonstrated remarkable success in the treatment of hematologic malignancies. However, currently approved CAR⁃T products are predominantly autologous, which face limitations including lengthy manufacturing processes, high costs, and the variability of product quality, restricting their broad clinical application. Universal CAR⁃T (UCAR⁃T) therapy, developed from healthy donor⁃derived T cells, through ex vivo modification and expansion, offer an "off⁃the⁃shelf" product that enable on⁃demand treatment, thereby overcoming the constraints of autologous CAR⁃T. Nevertheless, UCAR⁃T therapy remain challenged at complications including graft⁃versus⁃host disease (GvHD) and host⁃versus⁃graft reaction (HvG). This review summarizes recent progress on strategies to mitigate GvHD and HvG in UCAR⁃T therapy, including gene editing, non⁃gene⁃editing technologies, and optimal cell source selection.

Key words: Hematologic malignancies, CAR?T cell therapy, Universal CAR?T, Graft?versus?host disease, Host?versus?graft reaction 

中图分类号: 

  • R733