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Immuntherapien bei Kindern und Jugendlichen mit akuter lymphoblastischer Leukämie und hochmalignen Lymphomen

Immunotherapies for Children and Adolescents with Acute Lymphoblastic Leukemia and Highly Malignant Lymphoma

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Pädiatrie & Pädologie Aims and scope

Zusammenfassung

Mit der Entwicklung von Immuntherapien für Kinder und Jugendliche mit akuten lymphoblastischen Leukämien und hochmalignen Lymphomen, die zelluläre Oberflächenproteine zum Angriffsziel haben oder das körpereigene Immunsystem aktivieren, sollen die Überlebensraten bei gleichzeitiger Verringerung der akuten und späten Nebenwirkungen gesteigert werden. Der Einsatz von (un)konjugierten oder bispezifischen Antikörpern, Checkpoint-Inhibitoren und gentechnologisch veränderten T‑Lymphozyten mit synthetischen antigenspezifischen Rezeptoren (CAR-T-Zellen) gibt nunmehr Kindern und Jugendlichen mit resistenten oder mehrfach rezidivierten akuten lymphoblastischen Leukämien und hochmalignen Lymphomen die Chance auf die Induktion von molekularen bzw. bildgebenden Remissionen und definitive Heilungen. Jedoch könnten CAR-T-Zell-Therapien zukünftig bei früherem Einsatz im Rahmen der First- und Second-line-Therapien durch den Ersatz von konventioneller Chemotherapie und insbesondere allogener Stammzelltransplantation ihr Potenzial bezüglich gesteigerter Heilungsraten besser ausschöpfen.

Abstract

With the development of immunotherapies for children and adolescents with acute lymphoblastic leukemia and highly malignant lymphomas, which target cellular surface proteins or activate the body’s immune system, survival rates will increase, while reducing acute and late side effects. The use of (un)conjugated or bispecific antibodies, checkpoint inhibitors and genetically modified T‑lymphocytes with synthetic antigen-specific receptors (CAR-T cells) has recently provided children and adolescents with resistant or relapsed acute lymphoblastic leukemia and highly malignant lymphoma the chance of inducing molecular and imaging-defined remission and definitive cures. However, if used earlier in the context of first- and second-line therapies, CAR-T cell therapies could, by replacing conventional chemotherapy and especially allogeneic stem cell transplantation, better exploit their potential in terms of increased cure rates.

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  1. St. Anna Kinderspital, Univ. Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien (MUW), Kinderspitalgasse 6, 1090, Wien, Österreich

    Andishe Attarbaschi

  2. St. Anna Kinderkrebsforschung, Wien, Österreich

    Andishe Attarbaschi

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Correspondence to Andishe Attarbaschi.

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Attarbaschi, A. Immuntherapien bei Kindern und Jugendlichen mit akuter lymphoblastischer Leukämie und hochmalignen Lymphomen. Paediatr. Paedolog. 58, 276–282 (2023). https://doi.org/10.1007/s00608-023-01154-5

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