Palabras clave
Leucemia Mieloide Aguda
Terapia Molecular Dirigida
Seguridad
Eficacia
Cómo citar
Resumen
Introducción. La leucemia mieloide aguda (LMA) es una neoplasia hematológica agresiva con bajas tasas de supervivencia, especialmente en casos refractarios o en recaída. Aunque la terapia con células CAR-T ha revolucionado el manejo de otros cánceres hematológicos, su uso en LMA sigue siendo limitado, debido a la heterogeneidad antigénica y preocupaciones de seguridad. Métodos. Se revisaron sistemáticamente 43 estudios publicados entre 2020 y 2024 para evaluar la eficacia y seguridad de las terapias CAR-T dirigidas a antígenos como CLL-1, CD33, CD123 y CD70 en LMA. Se extrajeron datos sobre supervivencia, eventos adversos y respuestas específicas por antígeno. Resultados. CLL-1 mostró los mejores resultados, con una tasa de supervivencia del 60% a 6.2 meses en adultos y del 75% en pediátricos. CD33 y CD123 presentaron eficacia moderada, pero con mayor toxicidad hematológica. CD70 mostró tasas altas de respuesta, pero con efectos secundarios significativos (85% en estudios preclínicos). Antígenos emergentes como B7-H3 y estrategias de doble objetivo ofrecieron soluciones prometedoras para la heterogeneidad tumoral. Conclusiones. Las terapias CAR-T dirigidas a CLL-1 son altamente prometedoras para LMA por su especificidad y toxicidad manejable. Sin embargo, su implementación requiere superar desafíos relacionados con la variabilidad antigénica y la seguridad. En Colombia, estas terapias podrían transformar el manejo de la LMA, pero es necesario abordar barreras como los costos, la infraestructura y la capacidad de investigación local.
Citas
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