Nuevas aplicaciones de edición génica a la terapia celular adoptiva para el tratamiento de la leucemia mieloide aguda
Autores
Andrey Montero Bonilla
Resumen
La leucemia mieloide aguda (LMA) es una malignidad con severas complicaciones en pacientes en recaída y enfermedad refractaria. Para estos, los avances en tratamiento han sido escasos en las últimas tres décadas reduciéndose en muchos casos al trasplante de células madre hematopoyéticas, sin embargo, su uso es limitado.
La terapia celular adoptiva ha presentado grandes avances para el tratamiento del cáncer. Algunos inconvenientes como el tiempo de generación del producto terapéutico y la dificultad para obtener componentes celulares adecuados posterior a la quimioterapia, han mejorado de manera acelerada con la aparición de modelos de edición génica. Estos se enfocan en editar los receptores de linfocitos T asi como algunas moléculas del complejo principal de histocompatibilidad (MHC) logrando que estas terapias sean más accesibles, seguras y estén disponibles a tiempo para los pacientes.
En esta revisión, se realiza una aproximación a los principales inconvenientes que se presentan en el tratamiento de LMA, las nuevas aproximaciones con inmunoterapia celular adoptiva y herramientas de edición génica, asi como las perspectivas futuras.
Palabras clave
CAR-T, LMA, linfocito T, trasplante de células madre, terapia génica, inmunoterapia, CD33, alogénico, CRISPR.Abstract
Acute myeloid leukemia (AML) is a malignancy with severe clinical complications in patients refractory to treatment or who develop a relapse. Advances in treatment have been limited in the last three decades, with hematopoietic stem cell transplantation as the alternative for these patients; however, not all patients are candidates for this treatment, and sometimes, its access is limited.
Adoptive cell therapy has recently emerged as a potentially curative therapy in this type of cancer, and ongoing research is showing encouraging results. Nevertheless, some issues such as the time to generate therapeutic products, and the lack of adequate cell components after chemotherapy, make this therapeutic option difficult. To overcome these obstacles, new gene editing methods, focused on T cell receptors as well as Major Histocompatibility Complex (MHC), are improving these new therapeutical options, making them safe and available for patients.
In this review, we summarize the important issues driven by AML, new potential immunotherapies, gene editing tools, and address the present and future of research in this field.
Key words
CAR-T, AML, gene therapy, T lymphocyte, stem cell transplant , immunotherapy, CD33, allogeneic, CRISPRTexto completo
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