Adoptive cellular therapy with donor-derived T cells has always been an attractive strategy after allogeneic hematopoietic stem cell transplantation (allo-HSCT) to reduce the risk of relapse in acute myeloid and lymphoid leukemias. Donor lymphocyte infusion (DLI) is still the best-established option, especially in the preemptive phase when measurable residual disease (MRD) becomes positive and in the prophylactic setting—when MRD is not detectable. However, the clinical benefit of DLI is counterbalanced by the possible onset of graft-versus-host disease (GvHD), which continues to restrict its wide application. To address this challenge, several alternative cell-based strategies have been developed. One of these is represented by cytokine-induced killer (CIK) cells, generated from donor peripheral blood mononuclear cells through stimulation with anti-CD3 antibodies, interferon-γ, and interleukin-2. These cells are characterized by a hybrid phenotype, combining T-cell functions with natural killer-like properties, and exhibit antitumor activity in an MHC-unrestricted manner. CIK cells are generally well tolerated and associated with low toxicity but their efficacy is so far modest. Based on the experience of CAR-T in the treatment of B-cell lymphoid disease, CIK cells have been engineered with chimeric antigen receptors (CAR) developing the CARCIK cells. This novel cellular strategy represents a promising approach in the treatment of acute myeloid and lymphoid leukemia relapsed post-allo-HSCT. This review provides an overview of the current CAR-CIK experiences in the setting of acute leukemias and outlines future directions for their clinical translation.
采用供者来源的T细胞进行过继性细胞治疗，一直是异基因造血干细胞移植（allo-HSCT）后降低急性髓系和淋巴细胞白血病复发风险的理想策略。其中，供者淋巴细胞输注（DLI）仍是目前最成熟的选择，尤其适用于可测量残留病（MRD）转为阳性的抢先治疗阶段以及MRD未检测出的预防性治疗阶段。然而，DLI的临床获益常因可能诱发移植物抗宿主病（GvHD）而受限，这一风险持续制约其广泛应用。为应对这一挑战，多种基于细胞的替代策略应运而生。其中，细胞因子诱导的杀伤（CIK）细胞通过使用抗CD3抗体、干扰素-γ和白介素-2刺激供体外周血单个核细胞生成。这类细胞具有混合表型，兼具T细胞功能与自然杀伤样特性，能以非主要组织相容性复合体限制方式发挥抗肿瘤活性。CIK细胞通常耐受性良好且毒性较低，但其疗效迄今仍较为有限。基于嵌合抗原受体T细胞（CAR-T）治疗B细胞淋巴瘤的经验，研究者通过为CIK细胞装载嵌合抗原受体（CAR），开发出CARCIK细胞。这一新型细胞策略为治疗allo-HSCT后复发的急性髓系和淋巴细胞白血病提供了前景广阔的新途径。本综述系统梳理当前CAR-CIK细胞在急性白血病治疗中的应用经验，并展望其临床转化的未来发展方向。
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