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:Ocular adverse events associated with chimeric antigen receptor T-cell therapy: a case series and review.
Ocular adverse events associated with chimeric antigen receptor T-cell therapy: a case series and review.
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CAR-T 疗法在恶性肿瘤中的应用日益增多,凸显了眼科医生和肿瘤科医生了解其使用相关潜在毒性尤其是眼部毒性以及何时转诊进行眼科检查的重要性。
CAR-T 细胞疗法已被证明可提高难治性血液系统恶性肿瘤患者的缓解率和生存率。本研究旨在描述血液系统恶性肿瘤患者中与CAR-T 疗法相关的眼部不良反应。
这是一项回顾性、单机构、病例系列研究。纳入年龄在18岁及以上、因复发/难治性大B细胞淋巴瘤接受标准治疗CAR-T 疗法且有眼科评估记录的患者。主要结局是临床医生的眼科检查发现。
2018年2月至2019年10月,共有66例患者接受了CAR-T 细胞治疗,其中11例接受了眼科检查。11例接受CAR-T 细胞治疗的患者(n=22只眼)被纳入回顾。从CAR-T 细胞输注日期到眼科检查的中位时间为57.5天。检查时患者的中位年龄为60.5岁。10例患者有主观症状促使进行眼科检查。2例患者报告了飞蚊症和闪光感。1例患者出现眼部移植物抗宿主病恶化。2例患者被确定可能存在病毒感染再激活,包括眼部带状疱疹和消退中的急性视网膜坏死。
This is a retrospective, single-institution, case series. Patients aged 18 years or older who received standard of care CAR T therapy for relapsed/refractory large B-cell lymphoma with a documented ophthalmic evaluation were included. The primary outcome was clinician ophthalmic examination findings.
A total of 66 patients received CAR T-cell therapy from February 2018 to October 2019 with 11 receiving an ophthalmic examination. Eleven patients (n=22 eyes) who received CAR T-cell therapy were included in review. The median time from CAR T-cell infusion date to ocular examination was 57.5 days. The median patient age at the time of examination was 60.5 years. Ten patients had subjective symptoms prompting ophthalmic examination. Two patients reported floaters and photopsias. One patient had worsening ocular graft-versus-host disease. Two patients were identified with possible reactivation of viral infections, including herpes zoster ophthalmicus and regressing acute retinal necrosis.
The increasing use of CAR T therapy for malignancies underscores the importance of ophthalmologists and oncologists understanding the potential toxicities associated with its use, particularly ocular toxicities and when to refer for an ophthalmic examination.
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