Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada.
Arnie Charbonneau Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada.
Eur J Haematol. 2024 Jan;112(1):41-50. doi: 10.1111/ejh.14100. Epub 2023 Sep 28.
While cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome are well-recognized acute toxicities of chimeric antigen receptor (CAR) T cell therapy, these complications have become increasingly manageable by protocolized treatment algorithms incorporating the early administration of tocilizumab and corticosteroids. As CAR-T cell therapy expands to new disease indications and the number of long-term survivors steadily increases, there is growing recognition of the need to appropriately evaluate and manage the late effects of CAR-T cell therapy, including late-onset or persistent neurotoxicity, prolonged cytopenias, delayed immune reconstitution and infections, subsequent malignancies, organ dysfunction, psychological distress, and fertility implications. In this review, we provide a practical approach to the long-term survivorship care of the CAR-T cell recipient, with a focus on the optimal strategies to address the common and challenging late complications affecting this unique population.
虽然细胞因子释放综合征和免疫效应细胞相关神经毒性综合征是嵌合抗原受体（CAR）T 细胞治疗的公认急性毒性反应，但通过纳入托珠单抗和皮质类固醇早期给药的方案化治疗算法，这些并发症已变得越来越易于管理。随着 CAR-T 细胞治疗扩展到新的疾病适应证，以及长期幸存者的数量稳步增加，人们越来越认识到需要适当地评估和管理 CAR-T 细胞治疗的晚期效应，包括迟发性或持续性神经毒性、持续的血细胞减少、延迟的免疫重建和感染、随后的恶性肿瘤、器官功能障碍、心理困扰和生育影响。在这篇综述中，我们提供了一种针对 CAR-T 细胞受者的长期生存护理的实用方法，重点是解决影响这一独特人群的常见和具有挑战性的晚期并发症的最佳策略。
