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

多中心应用治疗性血浆置换治疗CAR-T疗法后对皮质类固醇/托珠单抗难治性细胞因子释放综合征的经验。

Multi-centers experience using therapeutic plasma exchange for corticosteroid/tocilizumab-refractory cytokine release syndrome following CAR-T therapy.

作者信息

Pu Yedi, Zhao Yifan, Qi Yuekun, Liu Yang, Zhang Meng, Xiao Xia, Lyu Hairong, Meng Juanxia, Zhu Haibo, Xu Kailin, Han Weidong, Zhao Mingfeng

机构信息

Department of Hematology, Tianjin First Central Hospital, Tianjin 300380, China.

The First Central Clinical College of Tianjin Medical University, Tianjin 300380, China.

出版信息

Int Immunopharmacol. 2024 Mar 30;130:111761. doi: 10.1016/j.intimp.2024.111761. Epub 2024 Feb 28.


DOI:10.1016/j.intimp.2024.111761
PMID:38422769
Abstract

The chimeric antigen receptor T (CAR-T) cell therapy significantly enhances the prognosis of various hematologic malignancies; however, the systemic expansion of CAR-T cells also gives rise to severe cytokine release syndrome (CRS), and immune effector cell-associated neurotoxicity syndrome (ICANS). Despite the successful application of corticosteroids and tocilizumab in alleviating severe CRS in most patients, there are still individuals who experience life-threatening CRS without responding to the aforementioned therapies. In our retrospective cohort, we conducted an analysis of clinical and laboratory parameters, including inflammatory cytokines, in 17 patients from three centers who underwent therapeutic plasma exchange (TPE) for refractory CRS with or without ICANS following CAR-T products treatment. Our findings demonstrate a significant improvement in both clinical symptoms and laboratory parameters subsequent to TPE treatment. The rapid decrease in temperature and levels of inflammatory indexes indicates the remarkable scavenging efficacy of TPE against cytokine storm following CAR-T therapy. In conclusion, TPE may serve as a valuable and safe adjunct to corticosteroids and tocilizumab in the management of severe CRS resulting from CAR-T cell infusion. We eagerly await further prospective studies to validate this finding.

摘要

嵌合抗原受体T(CAR-T)细胞疗法显著改善了各种血液系统恶性肿瘤的预后;然而,CAR-T细胞的全身扩增也会引发严重的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)。尽管皮质类固醇和托珠单抗成功应用于缓解大多数患者的严重CRS,但仍有个体出现危及生命的CRS且对上述治疗无反应。在我们的回顾性队列研究中,我们对来自三个中心的17例患者进行了临床和实验室参数分析,包括炎症细胞因子,这些患者在接受CAR-T产品治疗后因难治性CRS伴或不伴ICANS接受了治疗性血浆置换(TPE)。我们的研究结果表明,TPE治疗后临床症状和实验室参数均有显著改善。体温和炎症指标水平的快速下降表明TPE对CAR-T治疗后细胞因子风暴具有显著的清除效果。总之,在管理CAR-T细胞输注引起的严重CRS方面,TPE可能是皮质类固醇和托珠单抗的一种有价值且安全的辅助治疗方法。我们热切期待进一步的前瞻性研究来验证这一发现。

相似文献

[1]
Multi-centers experience using therapeutic plasma exchange for corticosteroid/tocilizumab-refractory cytokine release syndrome following CAR-T therapy.

Int Immunopharmacol. 2024-3-30

[2]
Anakinra for Refractory Cytokine Release Syndrome or Immune Effector Cell-Associated Neurotoxicity Syndrome after Chimeric Antigen Receptor T Cell Therapy.

Transplant Cell Ther. 2023-7

[3]
Early Use of Corticosteroids following CAR T-Cell Therapy Correlates with Reduced Risk of High-Grade CRS without Negative Impact on Neurotoxicity or Treatment Outcome.

Biomolecules. 2023-2-17

[4]
Tocilizumab for the treatment of chimeric antigen receptor T cell-induced cytokine release syndrome.

Expert Rev Clin Immunol. 2019-6-20

[5]
Prophylactic Tocilizumab Prior to Anti-CD19 CAR-T Cell Therapy for Non-Hodgkin Lymphoma.

Front Immunol. 2021

[6]
Cytokine release syndrome and neurotoxicity following CAR T-cell therapy for hematologic malignancies.

J Allergy Clin Immunol. 2020-11

[7]
Plasma Exchange Can Be an Alternative Therapeutic Modality for Severe Cytokine Release Syndrome after Chimeric Antigen Receptor-T Cell Infusion: A Case Report.

Clin Cancer Res. 2018-10-15

[8]
Single-center experience using anakinra for steroid-refractory immune effector cell-associated neurotoxicity syndrome (ICANS).

J Immunother Cancer. 2022-1

[9]
FDA Approval Summary: Tocilizumab for Treatment of Chimeric Antigen Receptor T Cell-Induced Severe or Life-Threatening Cytokine Release Syndrome.

Oncologist. 2018-4-5

[10]
CAR-T cell: Toxicities issues: Mechanisms and clinical management.

Bull Cancer. 2021-10

引用本文的文献

[1]
Cytokine release syndrome in solid tumors.

Cancer. 2025-9-1

[2]
Utilizing plasma exchange for severe cytokine release syndrome after CAR-T cell therapy: clinical experience and literature insights.

Front Immunol. 2025-6-24

[3]
Latest updates on pathogenesis mechanisms and management strategies for cytokine release syndrome, neurotoxicity, and hemophagocytic lymphohistiocytosis related to CAR-T cell therapies.

Ann Hematol. 2025-6-19

[4]
Deep insight into cytokine storm: from pathogenesis to treatment.

Signal Transduct Target Ther. 2025-4-16

[5]
Plasma exchange as an effective treatment for cytokine release syndrome following T cell receptor‑engineered T cell immunotherapy: A case report.

Oncol Lett. 2024-10-14

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