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嵌合抗原受体 T 细胞疗法的长期血液学毒性:综述。

Prolonged haematologic toxicity in CAR-T-cell therapy: A review.

机构信息

Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

J Cell Mol Med. 2023 Dec;27(23):3662-3671. doi: 10.1111/jcmm.17930. Epub 2023 Sep 13.

Abstract

Chimeric antigen receptor-T-cell (CAR-T-cell) therapy is a novel immunotherapy with encouraging results for treatment of relapsed/refractory haematologic malignancies. With increasing use, our understanding of immune-mediated side effects such as cytokine release syndrome and neurotoxicity has improved; nevertheless, prolonged haematologic toxicity (PHT), with a high incidence rate, remains underrecognized. Owing to heterogeneity in populations, the CAR-T cells used and diseases treated as well as differences in the definition of PHT, its rate, risk factors and management vary across studies. In this review, we provide a narrative of PHT occurring in patients following CAR-T-cell therapy; evidence of PHT treatment strategies is also presented, with the aim of contributing to systematic understanding of PHT.

摘要

嵌合抗原受体 T 细胞(CAR-T 细胞)疗法是一种新型免疫疗法,在治疗复发/难治性血液系统恶性肿瘤方面取得了令人鼓舞的结果。随着其应用的增加,我们对免疫介导的副作用(如细胞因子释放综合征和神经毒性)的认识有所提高;然而,发生率较高的持续性血液学毒性(PHT)仍未被充分认识。由于人群、使用的 CAR-T 细胞和治疗的疾病以及 PHT 的定义的异质性,其发生率、危险因素和管理在不同的研究中存在差异。在这篇综述中,我们描述了 CAR-T 细胞治疗后患者发生的 PHT;还提出了 PHT 治疗策略的证据,旨在促进对 PHT 的系统理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29b5/10718150/583d80e7fb1b/JCMM-27-3662-g001.jpg

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