Pediatric T-cell hematologic malignancies are a diverse group of rare cancers. The most common pediatric T-cell malignancies include T-cell acute lymphoblastic leukemia (T-ALL) and anaplastic large cell lymphoma (ALCL). Although the overall survival rates have improved markedly in recent years, children with relapsed T-ALL and ALCL have very low rates of cure and few salvage therapies exist. Current treatment regimens rely on toxic chemotherapies with significant short- and long-term morbidity. Immunotherapies, including antibodies and adoptive cellular therapies, have revolutionized the treatment of B-cell malignancies in pediatrics. The adaptation of these therapies to T-cell malignancies has been slower because of challenges implicit in the design and implementation of immunotherapies for T-cell malignancies, including the potential risks of fratricide, immunosuppression, and graft versus host disease (GVHD). We present a review of current challenges in the development of immunotherapies for T-cell hematologic malignancies, potential solutions and therapies under investigation. We include a particular focus on T-ALL and ALCL. Immunotherapies offer promising strategies to improve outcomes in children with T-cell malignancies, particularly in the setting of relapse. Optimizing efficacy, mitigating toxicity, and safely integrating with conventional therapies are key considerations as immunotherapies are translated into the clinic.

中文翻译：

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利用免疫疗法治疗小儿 T 细胞恶性肿瘤。

小儿 T 细胞血液系统恶性肿瘤是一组多样化的罕见癌症。最常见的儿科 T 细胞恶性肿瘤包括 T 细胞急性淋巴细胞白血病 (T-ALL) 和间变性大细胞淋巴瘤 (ALCL)。尽管近年来总体生存率显着提高，但复发性 T-ALL 和 ALCL 的儿童治愈率非常低，并且几乎没有补救治疗。目前的治疗方案依赖于具有显着短期和长期发病率的毒性化学疗法。免疫疗法，包括抗体和过继细胞疗法，已经彻底改变了儿科 B 细胞恶性肿瘤的治疗。由于 T 细胞恶性肿瘤免疫疗法的设计和实施中隐含的挑战，这些疗法对 T 细胞恶性肿瘤的适应较慢，包括自相残杀、免疫抑制和移植物抗宿主病 (GVHD) 的潜在风险。我们回顾了当前 T 细胞恶性血液病免疫疗法开发中的挑战、潜在的解决方案和正在研究的疗法。我们特别关注 T-ALL 和 ALCL。免疫疗法提供了有希望的策略来改善患有 T 细胞恶性肿瘤的儿童的预后，特别是在复发的情况下。随着免疫疗法进入临床，优化疗效、减轻毒性以及与传统疗法安全整合是关键考虑因素。正在研究的潜在解决方案和疗法。我们特别关注 T-ALL 和 ALCL。免疫疗法提供了有希望的策略来改善患有 T 细胞恶性肿瘤的儿童的预后，特别是在复发的情况下。随着免疫疗法进入临床，优化疗效、减轻毒性以及与传统疗法安全整合是关键考虑因素。正在研究的潜在解决方案和疗法。我们特别关注 T-ALL 和 ALCL。免疫疗法提供了有希望的策略来改善患有 T 细胞恶性肿瘤的儿童的预后，特别是在复发的情况下。随着免疫疗法进入临床，优化疗效、减轻毒性以及与传统疗法安全整合是关键考虑因素。