文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

免疫效应细胞相关性噬血细胞性淋巴组织细胞增生症样综合征。

Immune Effector Cell-Associated Hemophagocytic Lymphohistiocytosis-Like Syndrome.

机构信息

Department of Pediatric Medicine, Division of Critical Care, St. Jude Children's Research Hospital, Memphis, Tennessee.

Pediatric Hematology and Oncology, Seattle Children's Hospital and the University of Washington School of Medicine, Seattle, Washington.

出版信息

Transplant Cell Ther. 2023 Jul;29(7):438.e1-438.e16. doi: 10.1016/j.jtct.2023.03.006. Epub 2023 Mar 9.


DOI:10.1016/j.jtct.2023.03.006
PMID:36906275
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10330221/
Abstract

T cell-mediated hyperinflammatory responses, such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), are now well-established toxicities of chimeric antigen receptor (CAR) T cell therapy. As the field of CAR T cells advances, however, there is increasing recognition that hemophagocytic lymphohistiocytosis (HLH)-like toxicities following CAR T cell infusion are occurring broadly across patient populations and CAR T cell constructs. Importantly, these HLH-like toxicities are often not as directly associated with CRS and/or its severity as initially described. This emergent toxicity, however ill-defined, is associated with life-threatening complications, creating an urgent need for improved identification and optimal management. With the goal of improving patient outcomes and formulating a framework to characterize and study this HLH-like syndrome, we established an American Society for Transplantation and Cellular Therapy panel composed of experts in primary and secondary HLH, pediatric and adult HLH, infectious disease, rheumatology and hematology, oncology, and cellular therapy. Through this effort, we provide an overview of the underlying biology of classical primary and secondary HLH, explore its relationship with similar manifestations following CAR T cell infusions, and propose the term "immune effector cell-associated HLH-like syndrome (IEC-HS)" to describe this emergent toxicity. We also delineate a framework for identifying IEC-HS and put forward a grading schema that can be used to assess severity and facilitate cross-trial comparisons. Additionally, given the critical need to optimize outcomes for patients experiencing IEC-HS, we provide insight into potential treatment approaches and strategies to optimize supportive care and delineate alternate etiologies that should be considered in a patient presenting with IEC-HS. By collectively defining IEC-HS as a hyperinflammatory toxicity, we can now embark on further study of the pathophysiology underlying this toxicity profile and make strides toward a more comprehensive assessment and treatment approach.

摘要

T 细胞介导的过度炎症反应,如细胞因子释放综合征 (CRS) 和免疫效应细胞相关神经毒性综合征 (ICANS),现已成为嵌合抗原受体 (CAR) T 细胞治疗的明确毒性。然而,随着 CAR T 细胞领域的发展,人们越来越认识到,CAR T 细胞输注后出现噬血细胞性淋巴组织细胞增生症 (HLH) 样毒性在广泛的患者人群和 CAR T 细胞构建体中都有发生。重要的是,这些 HLH 样毒性与最初描述的 CRS 及其严重程度并不直接相关。这种新出现的毒性,尽管定义不明确,但与危及生命的并发症有关,因此迫切需要改进识别和最佳管理。为了改善患者的预后并构建一个框架来描述和研究这种 HLH 样综合征,我们成立了一个由原发性和继发性 HLH、儿科和成人 HLH、传染病、风湿病和血液学、肿瘤学和细胞治疗方面的专家组成的美国移植和细胞治疗学会小组。通过这项努力,我们提供了经典原发性和继发性 HLH 的基础生物学概述,探讨了其与 CAR T 细胞输注后类似表现的关系,并提出了“免疫效应细胞相关 HLH 样综合征 (IEC-HS)”这一术语来描述这种新出现的毒性。我们还描述了识别 IEC-HS 的框架,并提出了一个分级方案,可用于评估严重程度并促进跨试验比较。此外,鉴于患者出现 IEC-HS 时优化结局的迫切需要,我们提供了对潜在治疗方法的深入了解和优化支持性护理的策略,并描述了在出现 IEC-HS 的患者中应考虑的替代病因。通过将 IEC-HS 集体定义为一种过度炎症毒性,我们现在可以进一步研究这种毒性特征的病理生理学,并朝着更全面的评估和治疗方法迈进。

相似文献

[1]
Immune Effector Cell-Associated Hemophagocytic Lymphohistiocytosis-Like Syndrome.

Transplant Cell Ther. 2023-7

[2]
Case Report: Successful use of emapalumab in adult B-cell acute lymphoblastic leukemia experiencing severe neurotoxicity and hemophagocytic lymphohistiocytosis-like features after CAR-T cell therapy.

Front Immunol. 2025-4-4

[3]
Riding the storm: managing cytokine-related toxicities in CAR-T cell therapy.

Semin Immunopathol. 2024-7-16

[4]
Immune Effector Cell-associated Hemophagocytic Lymphohistiocytosis-like Syndrome (IEC-HS).

Hematol Oncol Clin North Am. 2025-6

[5]
Hemophagocytic lymphohistiocytosis post chimeric antigen receptor T cell therapies.

Expert Rev Clin Immunol. 2025-3

[6]
Current and emerging pharmacotherapies for cytokine release syndrome, neurotoxicity, and hemophagocytic lymphohistiocytosis-like syndrome due to CAR T cell therapy.

Expert Opin Pharmacother. 2024-2

[7]
Uncommon biphasic CAR-T expansion induces hemophagocytic lymphohistiocytosis-like syndrome and fatal multiple infections following BCMA CAR-T cell therapy: a case report.

J Immunother Cancer. 2024-11-27

[8]
A distinct cytokine network distinguishes chimeric antigen receptor T cell (CAR-T)-associated hemophagocytic lymphohistiocytosis-like toxicity (carHLH) from severe cytokine release syndrome following CAR-T therapy.

Cytotherapy. 2023-11

[9]
Cytokine Storms in COVID-19, Hemophagocytic Lymphohistiocytosis, and CAR-T Therapy.

JAMA Netw Open. 2025-4-1

[10]
Low utility of the H-Score and HLH-2004 criteria to identify patients with secondary hemophagocytic lymphohistiocytosis after CAR-T cell therapy for relapsed/refractory diffuse large B-Cell lymphoma.

Leuk Lymphoma. 2022-6

引用本文的文献

[1]
Biomarkers for an early diagnosis of immune effector cell associated-hemophagocytic syndrome.

Front Immunol. 2025-8-14

[2]
T cell redirecting therapy for relapsed multiple myeloma.

Discov Oncol. 2025-8-18

[3]
The Evolving Treatment Landscape for the Elderly Multiple Myeloma Patient: From Quad Regimens to T-Cell Engagers and CAR-T.

Cancers (Basel). 2025-8-5

[4]
Pharmacovigilance in Cell and Gene Therapy: Evolving Challenges in Risk Management and Long-Term Follow-Up.

Drug Saf. 2025-8-9

[5]
Tandem CD19/CD22 CAR T-cells as potential therapy for children and young adults with high-risk r/r B-ALL.

EBioMedicine. 2025-8

[6]
Venous Thromboembolic Events in Cancer Immunotherapy: A Narrative Review.

J Clin Med. 2025-7-11

[7]
Advances in Gene Therapy with Oncolytic Viruses and CAR-T Cells and Therapy-Related Groups.

Curr Issues Mol Biol. 2025-4-10

[8]
Novel Loop-Structure-Based CD19/CD22 Dual-Target CAR-T Therapy for High-Risk Diffuse Large B-Cell Lymphoma Presenting with Hemophagocytic Lymphohistiocytosis: A Case Report.

Cancer Manag Res. 2025-7-15

[9]
Toxicities associated with lymphoma-targeting bispecific antibodies-a review.

Front Med (Lausanne). 2025-7-2

[10]
[Management of side effects of CAR T cells].

Inn Med (Heidelb). 2025-7-8

本文引用的文献

[1]
Effect of granulocyte colony-stimulating factor on toxicities after CAR T cell therapy for lymphoma and myeloma.

Blood Cancer J. 2022-11-1

[2]
Limited efficacy of tocilizumab in adult patients with secondary hemophagocytic lymphohistiocytosis: a retrospective cohort study.

Orphanet J Rare Dis. 2022-9-21

[3]
Hyperinflammatory syndrome resembling haemophagocytic lymphohistiocytosis following axicabtagene ciloleucel and brexucabtagene autoleucel.

Br J Haematol. 2022-12

[4]
Allogeneic CD34-selected stem cell boost as salvage treatment of life-threatening infection and severe cytopenias after CAR-T cell therapy.

Transfusion. 2022-10

[5]
Safety and feasibility of stem cell boost as a salvage therapy for severe hematotoxicity after CD19 CAR T-cell therapy.

Blood Adv. 2022-8-23

[6]
CD34+-selected stem cell boost can safely improve cytopenias following CAR T-cell therapy.

Blood Adv. 2022-8-23

[7]
Dramatic Recovery after Etoposide Phosphate Infusion for Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome following Treatment with Tisagenlecleucel in a Young Patient with Relapsed Acute Lymphoblastic Leukemia: A Case Report.

Acta Haematol. 2022

[8]
HLH treatment: smarter, not harder.

Blood. 2022-6-16

[9]
Comprehensive Serum Proteome Profiling of Cytokine Release Syndrome and Immune Effector Cell-Associated Neurotoxicity Syndrome Patients with B-Cell ALL Receiving CAR T19.

Clin Cancer Res. 2022-9-1

[10]
CAR T cell killing requires the IFNγR pathway in solid but not liquid tumours.

Nature. 2022-4

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索