{"id":14110,"date":"2020-03-05T10:12:20","date_gmt":"2020-03-05T09:12:20","guid":{"rendered":"http:\/\/hemato.convergences.online\/?p=14110"},"modified":"2020-03-05T10:12:20","modified_gmt":"2020-03-05T09:12:20","slug":"car-nk-allogenique-dans-les-neoplasies-lymphoides-cd19","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/car-nk-allogenique-dans-les-neoplasies-lymphoides-cd19\/","title":{"rendered":"CAR NK allog\u00e9nique dans les n\u00e9oplasies lympho\u00efdes CD19+"},"content":{"rendered":"

R\u00e9f. :HematoStat.net ; 1 (1) : R2<\/p>\n

Liu E, Marin D, Banerjee P, and al. Use of CAR-Transduced Natural Killer Cells in CD19-Positive Lymphoid Tumors. N Engl J Med. 2020;382(6):545\u2013553. doi:10.1056\/NEJMoa1910607.<\/i><\/a><\/p>\n

R\u00e9sum\u00e9 de l\u2019article :<\/h3>\n

L\u2019av\u00e8nement des CAR T autologues a constitu\u00e9 un progr\u00e8s consid\u00e9rable, en particulier dans les h\u00e9mopathies B r\u00e9fractaires. N\u00e9anmoins ces th\u00e9rapies repr\u00e9sentent un d\u00e9fi \u00e9conomique et logistique et s\u2019accompagnent d\u2019une toxicit\u00e9 non n\u00e9gligeable.\u00a0<\/span>
\nLes \u00e9quipes du MD Anderson pr\u00e9sentent ici les r\u00e9sultats d\u2019une \u00e9tude de phase 1-2 utilisant comme plateforme des cellules NK provenant de cordons ombilicaux avec discordance HLA. Onze patients atteints de lymphomes ou de LLC r\u00e9fractaires ont pu \u00eatre trait\u00e9s. Huit patients ont pr\u00e9sent\u00e9s une r\u00e9ponse dont 7 une r\u00e9ponse compl\u00e8te. Il n\u2019y a pas eu de toxicit\u00e9 non h\u00e9matologique de grade III ou IV (aucun syndrome de relargage cytokinique).\u00a0<\/span><\/p>\n

Dans nos pratiques :<\/h3>\n

L\u2019utilisation de cellules NK d\u00e9riv\u00e9es de cordons ombilicaux parait prometteuse et pourrait contribuer \u00e0 rendre un peu plus accessible ces nouvelles th\u00e9rapies cellulaires. La discordance HLA ne semble pas \u00eatre probl\u00e9matique et le rendement est tr\u00e8s bon : il a \u00e9t\u00e9 possible de produire 100 doses \u00e0 partir d\u2019un seul cordon ombilical. Toutefois, le suivi limit\u00e9 ne permet pas encore de conna\u00eetre la persistance \u00e0 long terme de ces cellules chez les patients.<\/p>\n

Le regard du statisticien :<\/strong>
\nIl s’agit d’un essai de phase 1 et 2, en escalade de doses (3 niveaux) sur 11 patients. L’objectif principal de l’essai, c’est-\u00e0-dire, la d\u00e9termination de la dose maximale tol\u00e9r\u00e9e, n’est pas atteint. De plus, le suivi est seulement de 3 mois pour deux patients, et un patient a \u00e9t\u00e9 perdu de vu \u00e0 3 mois. Une analyse des donn\u00e9es observ\u00e9es a permis de\u00a0 <\/span>mettre en \u00e9vidence un plus grand nombre de copies des cellules CAR-NK chez les patients pr\u00e9sentant une r\u00e9ponse positive au traitement, par rapport aux patients en \u00e9chec. N\u00e9anmoins cette analyse n’est pr\u00e9sent\u00e9e qu’\u00e0 30 jours, et le sujet perdu de vue est alors consid\u00e9r\u00e9 comme ayant une r\u00e9ponse positive.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":14595,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[38,39,40],"ppma_author":[456],"class_list":["post-14110","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-car-nk","tag-escalade-de-doses","tag-neoplasies","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14110","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=14110"}],"version-history":[{"count":0,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14110\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=14110"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=14110"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=14110"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=14110"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}