嵌合抗原受体（CAR）T细胞疗法疗效的性别差异
Sex Differences in Outcomes of Chimeric Antigen Receptor (CAR) T-Cell Therapy.
作者信息
Tan Jia Yi, Yeo Yong Hao, Kin Hermon Wong Kha, Ang Qi Xuan, Chisti Mohammad Muhsin, Ezekwudo Daniel, Hilal Talal
机构信息
Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, New Jersey, USA.
Department of Internal Medicine/Pediatrics, Corewell Health, Royal Oak, Michigan, USA.
出版信息
Cancer Med. 2025 Mar;14(6):e70831. doi: 10.1002/cam4.70831.
BACKGROUND
Chimeric Antigen Receptor (CAR) T-cell therapy has arisen as a revolutionary treatment for hematologic malignancies. Our study aimed to evaluate how sex differences affect outcomes and complications following CAR T-cell therapy.
METHODS
Utilizing the Nationwide Readmissions Database (2018-2020), we identified patients and divided them into male and female groups. Hospital outcomes and complications were compared among these two groups after propensity score matching to match groups based on comorbidities, producing two comparable cohorts.
RESULTS
We analyzed 2928 patients (1832 males, 62.6%, mean age 60.3 ± 13.7 years; 1096 females, 37.4%, mean age 59.1 ± 13.8 years). After propensity score matching (1:1ratio), 1092 males and females were compared. There were no significant sex differences in early mortality (adjusted odd ratios (aOR): 1.04 [95% CI 0.69-1.57]), 30-day readmissions (aOR: 1.05 [95% CI 0.86-1.30]), or nonhome discharge (aOR: 0.89 [95% CI 0.60-1.31]). Females had higher odds of leukopenia (aOR: 1.26 [95% CI 1.06-1.50]) but lower odds of acute kidney injury (aOR: 0.68 [95% CI 0.52-0.88]).
CONCLUSIONS
No sex differences were found in hospital outcomes, including early mortality, 30-day readmission, and nonhome discharge after CAR T-cell therapy.
背景
嵌合抗原受体（CAR）T细胞疗法已成为血液系统恶性肿瘤的一种革命性治疗方法。我们的研究旨在评估性别差异如何影响CAR T细胞治疗后的疗效和并发症。
方法
利用全国再入院数据库（2018 - 2020年），我们识别出患者并将他们分为男性和女性组。在根据合并症进行倾向得分匹配以匹配组后，比较这两组的医院结局和并发症，从而产生两个可比队列。
结果
我们分析了2928例患者（1832例男性，占62.6%，平均年龄60.3±13.7岁；1096例女性，占37.4%，平均年龄59.1±13.8岁）。在倾向得分匹配（1:1比例）后，对1092例男性和女性进行了比较。在早期死亡率（调整后的优势比（aOR）：1.04 [95%置信区间0.69 - 1.57]）、30天再入院率（aOR：1.05 [95%置信区间0.86 - 1.30]）或非家庭出院率（aOR：0.89 [95%置信区间0.60 - 1.31]）方面，未发现显著的性别差异。女性白细胞减少的几率更高（aOR：1.26 [95%置信区间1.06 - 1.50]），但急性肾损伤的几率更低（aOR：0.68 [95%置信区间0.52 - 0.88]）。
结论
在CAR T细胞治疗后的医院结局方面，包括早期死亡率、30天再入院率和非家庭出院率，未发现性别差异。
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