RESUMEN
Chimeric antigen receptor (CAR)-modified T-cell therapy has achieved remarkable success in the treatment of acute lymphoblastic leukemia (ALL). Measurable/minimal residual disease (MRD) monitoring plays a significant role in the prognostication and management of patients undergoing CAR-T-cell therapy. Common MRD detection methods include flow cytometry (FCM), polymerase chain reaction (PCR), and next-generation sequencing (NGS), and each method has advantages and limitations. It has been well documented that MRD positivity predicts a poor prognosis and even disease relapse. Thus, how to perform prognostic evaluations, stratify risk based on MRD status, and apply MRD monitoring to guide individual therapeutic decisions have important implications in clinical practice. This review assesses the common and novel MRD assessment methods. In addition, we emphasize the critical role of MRD as a prognostic biomarker and summarize the latest studies regarding MRD-directed combination therapy with CAR-T-cell therapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT), as well as other therapeutic strategies to improve treatment effect. Furthermore, this review discusses current challenges and strategies for MRD detection in the setting of disease relapse after targeted therapy.
Asunto(s)
Humanos , Receptores Quiméricos de Antígenos/uso terapéutico , Neoplasia Residual , Trasplante Homólogo/métodos , Acondicionamiento Pretrasplante/métodos , Trasplante de Células Madre Hematopoyéticas/métodos , Recurrencia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapiaRESUMEN
【Objective】 To investigate the strategies against blood collection and supply in Hainan Province during the COVID-19 epidemic, so as to provide theoretical and technical support for ensuring blood balance and safety under epidemic situation. 【Methods】 Countermeasures of blood collection and supply against the COVID-19 epidemic, taken by blood centers in Hainan, were reviewed, and data from 2016 to 2020 were collected and analyzed to evaluate the effectiveness of countermeasures by comparison. 【Results】 During the COVID-19 epidemic, the total units of blood collected and issued continued to grow and the annual growth rate reached 10.3% in 2020. The proportion of blood donation by groups increased by 0.3%. The number of blood donations by soldiers and medical personnel has increased significantly, reaching 91.2% and 24.7%, respectively. 【Conclusion】 The countermeasures in Hainan during the COVID-19 epidemic achieved remarkable effects and ensured blood safety in the whole province, which provided references and experience for blood collection and supply under public emergencies.