CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Nutritional status alterations after chimeric antigen receptor T cell therapy in patients with hematological malignancies: a retrospective study.
Nutritional status alterations after chimeric antigen receptor T cell therapy in patients with hematological malignancies: a retrospective study.
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不同营养相关生化指标在 CAR-T 细胞治疗后变化各异。CAR-T 细胞输注后白蛋白和总胆固醇水平与细胞因子释放综合征分级呈负相关。接受 CAR-T 细胞治疗患者的营养不良特异性筛查和干预有待进一步研究探索。
创新性CAR-T 细胞疗法对血液系统恶性肿瘤患者营养状况的影响尚不清楚。因此,我们旨在探讨血液系统恶性肿瘤患者接受CAR-T 细胞治疗后营养状况的变化。
我们回顾性收集了2018年至2020年在我院接受CAR-T 治疗的急性白血病(AL)、淋巴瘤和多发性骨髓瘤(MM)患者的数据。比较并分析了CAR-T 细胞输注前及输注后7、14、21天的血清白蛋白、甘油三酯和胆固醇。
共纳入117例患者,包括39例AL、23例淋巴瘤和55例MM患者。基线白蛋白、甘油三酯和胆固醇分别为37.43 5.08 mg/L、1.63 0.74 mmol/L和3.62 1.03 mmol/L。与基线相比,CAR-T 细胞输注后7天白蛋白水平最低(P < 0.001),而甘油三酯水平在14天和21天升高(P < 0.001,P = 0.036)。CAR-T 细胞输注后7天、14天和21天的胆固醇水平均低于基线(均P < 0.05)。Spearman相关系数显示,细胞因子释放综合征分级与CAR-T 细胞输注后7天白蛋白水平和21天胆固醇水平呈负相关(r = - 0.353,P < 0.001;r = - 0.395,P = 0.002)。
The influence of innovative chimeric antigen receptor T cell (CAR-T) therapy for hematological malignancies on nutritional status remains unknown. Therefore, we aim to explore the alterations of nutritional status after CAR-T cell therapy in patients with hematological malignancies.
We retrospectively collected the data of patients with acute leukemia (AL), lymphoma, and multiple myeloma (MM), who underwent CAR-T therapy at our hospital from 2018 to 2020. The serum albumin, triglyceride, and cholesterol before and 7, 14, and 21 days after CAR-T cell infusion were compared and analyzed. RESULT: A total of 117 patients were enrolled, consisting of 39 AL, 23 lymphoma, and 55 MM patients. The baseline albumin, triglyceride, and cholesterol were 37.43 5.08 mg/L, 1.63 0.74 mmol/L, and 3.62 1.03 mmol/L, respectively. The lowest albumin level was found at 7 days after CAR-T cell infusion compared with baseline (P < 0.001), while the levels of triglyceride increased at 14 and 21 days (P < 0.001, P = 0.036). The levels of cholesterol at 7, 14, and 21 days after CAR-T cell infusion were lower than baseline (all P < 0.05). Spearman's correlation coefficient showed cytokine release syndrome grade was negatively correlated with the levels of albumin at 7 days and cholesterol at 21 days after CAR-T cell infusion (r = - 0.353, P < 0.001; r = - 0.395, P = 0.002).
The alterations of different nutrition-related biochemical parameters varied after CAR-T cell therapy. The levels of albumin and total cholesterol after CAR-T cell infusion were negatively correlated with the grade of cytokine release syndrome. Specific screening and intervention for malnutrition in patients receiving CAR-T cell therapy need to be explored in further studies.
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