III. Reading Comprehension 第 17 題至第 21 題為題組         It’s been about half a century since the first transplant of bone marrow from adonor to a recipient was completed. Since then, bone marrow transplantation hasbecome an integral part of care for many patients with persistent leukemia, lymphoma,multiple myeloma and other blood cancers, as well as noncancerous blood disorderssuch as sickle cell disease. Specifically, we are transplanting stem cells — nascent cellswith the capacity to mature into functioning blood and immune system cells — from amatched or partially matched donor into the body of a patient whose own blood-formingsystem has been destroyed with toxic medication to make way for a healthy new systemto grow and develop.
        In recent years, however, our field has expanded to include other treatments thatwork in similar ways as bone marrow transplantation. They are collectively known as"cellular therapies" because they do one of three things: provide healthy new cells toreplace diseased cells, release an influx of specially modified immune cells to teach thebody's immune cells how to fight disease, or provide cells that connect immune cellswith cancer cells they are designed to kill. Study after study has demonstrated how theseapproaches are extending patients' lives. This progression of therapies is reflected inbone marrow transplant services around the country, many of which — including ourown at Hackensack University Medical Center — now include the words "cellulartherapy" in their names.         It is an exciting time for those of us in the stem cell transplantation and cellulartherapy field. For years, we have concentrated on improving the outcomes of stem celltransplants. We have significantly improved techniques to reduce the risk of graftversus-host disease, a potentially serious complication of transplantation that occurswhen immune cells from the donor identify the tissues of the recipient as foreign andattack them, causing a host of inflammatory symptoms. We have learned whichmedications to give to prevent post-transplant infections such as cytomegalovirus, acommon virus that can be damaging in people with compromised immune systems. Weare using stem cells from umbilical cord blood to perform more transplants in adultpatients. And we have matched more patients with donors by learning how to perform"haploidentical" transplants, where the patient receives a transplant from someonewhose particular protein in their cells is partially matched with theirs. These advancesare making stem cell transplantation a safer and more effective treatment option formore patients who need them.
          But where we are really seeing a revolution in care is the field of cellular therapy— particularly CAR T-cell immunotherapy. Cancer cells have found ways to escapebeing detected and destroyed by immune cells. Immunotherapies work by helping theimmune system find and kill cancer cells.
          With CAR T-cell therapy, immune cells called T cells are removed from thepatient, genetically modified in a lab to recognize and attach to certain targets on cancercells, grown to larger quantities (hundreds of millions), and returned to the patient.There, the modified T cells can find, bind to and kill cancer cells. The treatment is givenintravenously. Long after the patient goes home, however, his or her newly educatedimmune cells continue to detect and destroy cancer cells, which is why this treatmentis often referred to as a "living therapy."           CAR T-cell therapies are typically administered in bone marrow transplantationunits, and for good reason: Patients receive chemotherapy beforehand, which reducesthe immune response. The treatment itself can cause immunologic side effects which,albeit temporary, can be severe — including high fever, body aches and chills. Theadministration of CAR T-cell therapies requires round-the-clock care from a speciallytrained and credentialed team. As bone marrow transplant specialists, our experienceand knowledge of immunology enable us to recognize and manage the inflammatorycomplications that may result.            Current CAR T-cell therapies are FDA-approved for the treatment of recurrent orpersistent diffuse B-cell lymphoma, follicular lymphoma, multiple myeloma andmantle cell lymphoma (which is a very aggressive and challenging cancer) in adults, aswell as acute lymphoblastic leukemia in children and young adults up to age 25. Weare intrigued by other innovative cellular therapies under study in clinical trials, suchas natural killer (NK) cells and tumor-infiltrating lymphocytes (TILs). These treatmentsare made from a patient's own tumor tissue, so it has already been exposed to thepatient's own immune system. Immune cells within a tumor, which on their own wereunable to kill the cancer, are isolated from tumor tissue removed during surgery,modified and multiplied in a lab, and returned to the patient with other medications toboost the immune response against cancer.           Not only is the technology getting better, but the types of tumors we are treatingis broadening. New CAR T-cell therapies, NK and TIL treatments, and anotherapproach that combines CAR T-cell and NK therapies may broaden the application ofthese "living therapies" to patients with solid tumors, including melanoma, breastcancer and pancreatic cancer. We're also looking at combining cellularimmunotherapies with stem cell transplantation to augment the anticancer immuneresponse even further.          It has been inspirational for us as bone marrow transplant professionals to be partof their development. What we're witnessing now is just the tip of the iceberg. We'reonly getting better at identifying the best immune cells and engineering them in the bestfashion to harness the immune system in the most effective way. Discovery isexponential and the field of immunotherapy is growing at warp speed. It's notimpossible to think that we're going to be curing cancer.[!--empirenews.page--]
【題組】17. Which of the following is the best title for this article?
(A) Cellular Therapies Hit Their Stride in Cancer Care
(B) Immunotherapies: Game Changers in Chemotherapy
(C) Immunotherapies: A Watershed in the Treatment of Neurotic Disorders
(D) Cellular Therapies Hold Out the Promise of Improved Bone Marrow Transplants