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抗 CD19 嵌合抗原受体 T 细胞治疗后进行性多灶性白质脑病的迟发。

Late occurrence of progressive multifocal leukoencephalopathy after anti-CD19 chimeric antigen receptor T-cell therapy.

机构信息

Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.

Department of Neurology, Cleveland Clinic, Cleveland, OH, USA.

出版信息

Eur J Haematol. 2021 Apr;106(4):584-588. doi: 10.1111/ejh.13583. Epub 2021 Feb 2.

Abstract

Progressive multifocal leukoencephalopathy (PML) is a life-threatening infection of the central nervous system in immunocompromised patients, with an established predilection in non-Hodgkin's lymphoma and stem cell transplant recipients. In the era of chimeric antigen receptor T-cell therapy (CAR T-cell), the occurrence of new-onset neurological symptoms and encephalopathy in this patient population can be attributed to a variety of factors, including therapy-related neurotoxicity or disease progression. PML has not been implicated as a common cause of encephalopathy in CAR T-cell therapy recipients, and the identification of such rare infections is important to guide prognosis and treatment decisions. We hereby report the first case of late occurrence of PML, over one year after CAR T-cell therapy, for a patient with relapsed large B-cell lymphoma.

摘要

进行性多灶性白质脑病(PML)是一种危及生命的中枢神经系统感染,易发生于免疫功能低下的患者,在非霍奇金淋巴瘤和干细胞移植受者中已确立了易感性。在嵌合抗原受体 T 细胞疗法(CAR T 细胞)时代,此类患者群体新发神经症状和脑病可归因于多种因素,包括治疗相关神经毒性或疾病进展。PML 尚未被认为是 CAR T 细胞治疗受者中常见的脑病原因,因此识别此类罕见感染对于指导预后和治疗决策非常重要。我们在此报告首例 CAR T 细胞治疗一年多后发生的 PML 迟发性病例,患者为复发性大 B 细胞淋巴瘤。

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