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
CD19 靶向 CAR-T 细胞过继免疫治疗后继发性中枢神经系统淋巴瘤的毒性与缓解率
英文原题：Toxicities and Response Rates of Secondary CNS Lymphoma After Adoptive Immunotherapy With CD19-Directed Chimeric Antigen Receptor T Cells.
查看英文原题
Toxicities and Response Rates of Secondary CNS Lymphoma After Adoptive Immunotherapy With CD19-Directed Chimeric Antigen Receptor T Cells.
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研究概要
CAR-T 细胞在 SCNSL 中诱导了显著的抗肿瘤效应，且 CNS 反应反映了全身反应。神经毒性与既往关于无 CNS 受累的淋巴瘤患者的报道相似。因此，CAR-T 细胞可能代表一种对 SCNSL 有效且安全的疗法。
研究思路结论见上方概要
背景
系统性B细胞淋巴瘤的继发性中枢神经系统受累（SCNSL）难以治疗，临床结局不佳。嵌合抗原受体（CAR）T细胞已成为系统性淋巴瘤的有力治疗手段。我们旨在评估CAR-T 细胞是否也可作为SCNSL安全有效的治疗方法。
方法
我们回顾性检索了本机构数据库，以寻找接受CD19靶向CAR-T 细胞治疗的SCNSL患者。
结果
我们识别出10例病例，包括7例脑实质病变患者和3例软脑膜疾病患者。CAR-T 细胞输注后1个月的中枢神经系统分期显示，7例患者（70%）出现疾病缓解（疾病稳定、部分缓解和完全缓解），其中包括2例持久完全缓解（20%）。1例患者出现假性进展，经类固醇治疗后消退。中枢神经系统疾病的缓解与全身1个月缓解相关。中位随访时间为6个月，中位总生存期和全身无进展生存期分别为7个月和3个月。6例患者出现神经毒性症状，其中3例发生严重神经毒性（美国移植与细胞治疗学会3级）。
展开英文摘要原文
METHODS
We retrospectively searched our institutional database for patients with SCNSL treated with CD19-directed CAR T cells.
RESULTS
We identified 10 cases, including 7 patients with intraparenchymal lesions and 3 patients with leptomeningeal disease. CNS staging at 1 month after CAR T-cell transfusion showed disease response (stable disease, partial response, and complete response) in 7 patients (70%), including 2 cases of long-lasting complete response (20%). One patient developed pseudoprogression, which resolved under steroids. Response of CNS disease was associated with systemic 1-month response. With a median follow-up of 6 months, median overall and systemic progression-free survival was 7 and 3 months, respectively. Neurotoxic symptoms occurred in 6 patients, with 3 patients developing severe neurotoxicity (American Society for Transplantation and Cellular Therapy grade 3). DISCUSSION: CAR T cells induce considerable antitumor effects in SCNSL, and CNS response reflects systemic response. Neurotoxicity appears similar to previous reports on patients with lymphoma without CNS involvement. CAR T cells may therefore represent an effective and safe therapy for SCNSL.
论文信息
- 作者
- Karschnia P、Rejeski K、Winkelmann M、Schöberl F、Bücklein VL、Blumenberg V、Schmidt C、Blobner J
- 单位
- From the Department of Neurosurgery (P.K., J.B., J.-C.T., L.B.), University Hospital, LMU (Ludwig-Maximilians-University) Munich; German Cancer Consortium (DKTK) (P.K., K.R., V.B., C.S., J.B., M.B.-B., J.-C.T., M.S., L.B.), Partner Site Munich; Department of Medicine III - Hematology/Oncology (K.R., V.L.B., V.B., C.S., M.B.-B., M.S.), University Hospital, LMU (Ludwig-Maximilians-University) Munich; Department of Radiology (M.W., W.G.K.), University Hospital, LMU (Ludwig-Maximilians-University) Munich; and Department of Neurology (F.S., L.B.), University Hospital, LMU (Ludwig-Maximilians-University) Munich, Germany.Germany
- 文献类型
- 非美国政府资助研究
- 期刊
- Neurology2022 May 24
- 原文标识
- PubMed 35351785 · DOI 10.1212/WNL.0000000000200608
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