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嵌合抗原受体T细胞免疫疗法相关噬血细胞性淋巴组织细胞增生症:与细胞因子释放综合征相比的发病机制、临床表现、诊断及管理(综述)

Chimeric antigen receptor T cell immunotherapy‑associated hemophagocytic lymphohistiocytosis: Pathogenesis, clinical manifestation, diagnosis and management compared with cytokine release syndrome (Review).

作者信息

Hu Jinglin, Feng Cuicui, He Lingbo, Wang Yini

机构信息

Department of Hematology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China.

Department of General Practice, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China.

出版信息

Mol Med Rep. 2025 Aug;32(2). doi: 10.3892/mmr.2025.13578. Epub 2025 May 26.

Abstract

Chimeric antigen receptor (CAR) T cell therapy is used to treat hematological malignancy. However, it carries the risk of life‑threatening inflammatory toxicity, including cytokine release syndrome (CRS) and CAR T cell‑associated hemophagocytic lymphohistiocytosis (CARHLH). CRS is a common side effect of CAR T cell therapy, with fever and multiorgan functional impairment as the primary clinical manifestation. CARHLH and CRS have similar clinical manifestations. However, CARHLH is associated with a high mortality rate. CARHLH was previously considered a specific type of CRS, however, it must be promptly differentiated from CRS for treatment initiation, with management differing from that of CRS. The pathogenesis of CARHLH differs from that of CRS. The present review aimed to summarize the pathogenesis, diagnosis and treatment of CARHLH to assist in its early identification and management.

摘要

嵌合抗原受体(CAR)T细胞疗法用于治疗血液系统恶性肿瘤。然而,它存在危及生命的炎症毒性风险,包括细胞因子释放综合征(CRS)和CAR T细胞相关噬血细胞性淋巴组织细胞增生症(CARHLH)。CRS是CAR T细胞疗法的常见副作用,主要临床表现为发热和多器官功能损害。CARHLH与CRS有相似的临床表现。然而,CARHLH的死亡率很高。CARHLH以前被认为是CRS的一种特殊类型,然而,为了开始治疗,必须迅速将其与CRS区分开来,其管理方式与CRS不同。CARHLH的发病机制与CRS不同。本综述旨在总结CARHLH的发病机制、诊断和治疗,以帮助早期识别和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4448/12134842/f3177e6bb79e/mmr-32-02-13578-g00.jpg

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