Castaneda-Puglianini Omar, Chavez Julio C
Virginia Commonwealth University, Massey Cancer Center, Cellular Immunotherapies and Transplant Program, Richmond, VA, USA.
Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA.
J Blood Med. 2021 Aug 24;12:775-783. doi: 10.2147/JBM.S281247. eCollection 2021.
Chimeric antigen receptor T-cell (CAR-T) therapy represents the most important advances in cancer immunotherapy, especially in hematological malignancies such as B-cell lymphomas. CAR-T cell therapy has significant activity in poor risk B-cell lymphomas. CAR-T cell therapy is associated with potentially life-threatening toxicities such as cytokine release syndrome (CRS) and neurotoxicity (NT). While CRS pathophysiology and management are well established, the understanding and treatment of NT continues to develop. All current CAR-T products approved for DLBCL have been associated with NT with some differences in their severity. As cell therapies continue to advance and its access broadening, it will be imperative for clinicians to be aware of the signs and symptoms of NT, its stratification and basic management.
嵌合抗原受体T细胞（CAR-T）疗法是癌症免疫疗法中最重要的进展，尤其是在B细胞淋巴瘤等血液系统恶性肿瘤方面。CAR-T细胞疗法在预后不良的B细胞淋巴瘤中具有显著活性。CAR-T细胞疗法与细胞因子释放综合征（CRS）和神经毒性（NT）等潜在危及生命的毒性相关。虽然CRS的病理生理学和管理已得到充分确立，但对NT的认识和治疗仍在不断发展。目前所有获批用于弥漫性大B细胞淋巴瘤（DLBCL）的CAR-T产品都与NT相关，只是严重程度有所不同。随着细胞疗法的不断进步及其可及性的扩大，临床医生必须了解NT的体征和症状、分层及基本管理。
