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[接受嵌合抗原受体T细胞(CAR-T)治疗血液系统恶性肿瘤患者的免疫监测:CARTi组及法语国家骨髓移植与细胞治疗协会(SFGM-TC)指南]

[Immunomonitoring of patients treated with CAR-T cells for hematological malignancy: Guidelines from the CARTi group and the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)].

作者信息

Rubio Marie Thérèse, Varlet Pauline, Allain Vincent, Ballot Caroline, Cuffel Alexis, Deschamps Marina, Ferrand Christophe, Foguenne Jacques, Forcade Edouard, Huynh Anne, Guihot Amélie, Latouche Jean-Baptiste, Lemarie Claude, Martinroche Guillaume, Morin Florence, Nguyen Stéphanie, Schmit Kathleen, Servais Sophie, Simonetta Federico, Yakoub-Agha Ibrahim, Caillat Zucman Sophie

机构信息

CHRU Nancy, Hopital Brabois, Biopole de l'Université de Lorraine, CNRS UMR 7563 IMoPa, Service d'hématologie, 54500 Vandoeuvre-les-Nancy, France.

Université de Lille, CHU de Lille, Laboratoire d'Immunologie, LIRIC, INSERM U995, 59000 Lille, France.

出版信息

Bull Cancer. 2021 Dec;108(12S):S53-S64. doi: 10.1016/j.bulcan.2021.04.008. Epub 2021 Jul 9.

Abstract

CAR-T cells represent a new anti-tumor immunotherapy which has shown its clinical efficacy in B-cell malignancies. The results of clinical trials carried out in this context have shown that certain immunological characteristics of patients before (at the time of apheresis) and after the administration of the treatment, or of the CAR-T cells themselves, are correlated with the response to the treatment or to its toxicity. However, to date, there are no recommendations on the immunological monitoring of patients treated in real life. The objectives of this workshop were to determine, based on data from the literature and the experience of the centers, the immunological analyses to be carried out in patients treated with CAR-T cells. The recommendations relate to the characterization of the patient's immune cells at the time of apheresis, the characterization of the injected CAR-T cells, as well as the monitoring of the CAR-T cells and other parameters of immune reconstitution in the patient after administration of the treatment. Harmonization of practices will allow clinical-biological correlation studies to be carried out in patients treated in real life with the aim of identifying factors predictive of response and toxicity. Such data could have a major medico-economic impact by making it possible to identify the patients who will optimally benefit from these expensive treatments.

摘要

嵌合抗原受体T细胞(CAR-T细胞)代表了一种新型抗肿瘤免疫疗法,已在B细胞恶性肿瘤中显示出临床疗效。在此背景下开展的临床试验结果表明,患者在治疗前(采集血细胞时)和治疗给药后,或者CAR-T细胞本身的某些免疫学特征,与治疗反应或毒性相关。然而,迄今为止,对于在实际临床中接受治疗的患者的免疫监测尚无相关建议。本次研讨会的目的是根据文献数据和各中心的经验,确定在接受CAR-T细胞治疗的患者中应进行的免疫学分析。这些建议涉及采集血细胞时患者免疫细胞的特征分析、注入的CAR-T细胞的特征分析,以及治疗给药后患者体内CAR-T细胞的监测和免疫重建的其他参数。实践的统一将有助于在实际临床中接受治疗的患者中开展临床-生物学相关性研究,以识别预测反应和毒性的因素。这些数据通过识别能够从这些昂贵治疗中获得最佳疗效的患者,可能会产生重大的医学经济影响。

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