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[嵌合抗原受体T细胞疗法患者感染的预防与管理:法语国家骨髓移植与细胞治疗协会(SFGM-TC)的建议]

[Prevention and management of infections in patients undergoing CAR T-cell therapy: Recommendations of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)].

作者信息

Paul Franciane, Vicente Céline, Courbon Corinne, Moreau Anne-Sophie, Picard Muriel, Pochon Cécile, Sterin Arthur, Tudesq Jean-Jacques, Yakoub-Agha Mathilde, Bay Jacques-Olivier, Yakoub-Agha Ibrahim

机构信息

CHU de Montpellier, hôpital Saint-Eloi, département d'hématologie clinique, 80, avenue Augusin-Fliche, 34090 Montpellier, France.

CHU de Toulouse, service d'hématologie, IUCT-oncopole, 1, avenue Joliot-Curie, 31059 Toulouse, France.

出版信息

Bull Cancer. 2021 Dec;108(12S):S90-S97. doi: 10.1016/j.bulcan.2021.11.001. Epub 2021 Dec 6.

Abstract

Infections occurring after CAR T-cells are a common complication. At the acute phase of treatment following CAR T-cell infusion, the exact incidence of infections is unknown given the overlapping symptoms with cytokine release syndrome. The risk factors for infection include the malignant underlying disease and its multiple treatments, and an immunosuppressive state induced by CAR-T cells themselves and the treatment of their complications. During the twelfth edition of practice harmonization workshops of the Francophone society of bone marrow transplantation and cellular therapy (SFGM-TC), a working group focused its work on the management of post-CAR infectious complications. In this review we discuss anti-infection prophylaxis and vaccination of patients undergoing CAR T-cell therapy as well as a special chapter for the specific case of COVID-19. These recommendations apply to commercial CAR-T cells, in order to guide strategies for the management and prevention of infectious complications associated with this new therapeutic approach.

摘要

嵌合抗原受体(CAR)T细胞治疗后发生的感染是一种常见并发症。在CAR T细胞输注后的治疗急性期,鉴于与细胞因子释放综合征症状重叠,感染的确切发生率尚不清楚。感染的风险因素包括潜在恶性疾病及其多种治疗,以及CAR-T细胞本身及其并发症治疗所诱导的免疫抑制状态。在法语国家骨髓移植和细胞治疗协会(SFGM-TC)第十二版实践协调研讨会上,一个工作组将工作重点放在CAR治疗后感染并发症的管理上。在本综述中,我们讨论了接受CAR T细胞治疗患者的抗感染预防和疫苗接种,以及针对2019冠状病毒病(COVID-19)特殊情况的一个专门章节。这些建议适用于商业CAR-T细胞,以指导与这种新治疗方法相关的感染并发症的管理和预防策略。

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