Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, PR China; Jiangxi Key Laboratory of Molecular Medicine, The Second Affiliated Hospital of Nanchang University, PR China.
Department of Nephrology, Ganzhou People's Hospital, Ganzhou, PR China.
Clin Immunol. 2024 Sep;266:110311. doi: 10.1016/j.clim.2024.110311. Epub 2024 Jul 10.
Chimeric antigen receptor T cell (CAR-T) therapy is a promising treatment for hematologic tumors, and adverse events of acute kidney injury (AKI) have been reported. However, its incidence, clinical characteristics, and prognosis remained unclear. We searched PubMed, EMBASE, and Web of Science for study about AKI after CAR-T therapy, a total of 15 studies, comprising 694 patients, were included. Among the 694 patients, 154 (22%) developed AKI, of which 89 (57.8%) were in stage 1, 59 (38.3%) were in stage 2 or 3, and 6 (3.9%) were not reported. Cytokine release syndrome is considered to be the most common cause of AKI. Of the 154 AKI patients, only 16 (10.4%) received renal replacement therapy, most AKI recovered renal function after symptomatic treatment. Although the occurrence of AKI after CAR-T therapy is rare and mostly mild, active knowledge of its pathogenesis, timely diagnosis and treatment are necessary for clinicians.
嵌合抗原受体 T 细胞（CAR-T）疗法是一种有前途的血液系统肿瘤治疗方法，已有急性肾损伤（AKI）的不良反应报告。然而，其发病率、临床特征和预后仍不清楚。我们检索了 PubMed、EMBASE 和 Web of Science 中关于 CAR-T 治疗后 AKI 的研究，共纳入了 15 项研究，包含 694 例患者。在这 694 例患者中，有 154 例（22%）发生了 AKI，其中 89 例（57.8%）处于 1 期，59 例（38.3%）处于 2 期或 3 期，6 例（3.9%）未报告。细胞因子释放综合征被认为是 AKI 的最常见原因。在这 154 例 AKI 患者中，仅有 16 例（10.4%）接受了肾脏替代治疗，大多数 AKI 在症状治疗后恢复了肾功能。尽管 CAR-T 治疗后 AKI 的发生率较低且多为轻度，但临床医生需要积极了解其发病机制，及时诊断和治疗。
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