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:Outcomes of Tisagenlecleucel in Lymphoma Patients With Predominant Management in an Ambulatory Setting.
Outcomes of Tisagenlecleucel in Lymphoma Patients With Predominant Management in an Ambulatory Setting.
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我们的经验证实,在密切监测和充分的机构经验条件下,于门诊环境中使用 tisagenlecleucel 治疗是安全且可行的。
开展单中心回顾性研究,调查2017年10月至2020年12月期间接受商业化tisagenlecleucel治疗的成人淋巴瘤患者。分析患者特征及疗效和安全性结局,包括总缓解率、无进展生存期、总生存期、细胞因子释放综合征、神经毒性和住院情况。
共确定72名接受商业化tisagenlecleucel治疗的复发/难治性非霍奇金淋巴瘤(NHL)患者,其中68人(94.4%)在门诊接受治疗。总缓解率为43%,25人(34.7%)完全缓解。中位随访9.1个月时,无进展生存期中位数为3.3个月。研究组未发生3~4级细胞因子释放综合征,2名患者出现3~4级神经毒性。输注后30天内有26人(36.1%)住院,住院时间中位数为5天;14人(19.4%)在输注后72小时内住院。无人死于CAR-T 相关毒性。
我们的经验表明,在密切监护且机构经验充分的情况下,门诊给予tisagenlecleucel安全可行。输注后不良事件可控,多数患者无需住院。
We conducted a single institution, retrospective study investigating outcomes of adult lymphoma patients treated with commercial tisagenlecleucel between 10/2017 and 12/2020. We analyzed patient characteristics and outcomes of efficacy and safety including overall response rate, progression-free survival, overall survival and cytokine-release syndrome, neurotoxicity, and hospitalizations.
Seventy-two patients with relapsed or refractory non-Hodgkin lymphoma (NHL) who received commercial tisagenlecleucel were identified; 68 (94.4%) patients received outpatient tisagenlecleucel. The overall response rate was 43% with a complete response observed in 25 patients (34.7%). At a median follow-up of 9.1 months, the median progression-free survival was 3.3 months. Grade 3-4 cytokine release syndrome was not observed in the study group and two patients had grade 3-4 neurotoxicity. Twenty-six patients (36.1%) were admitted within 30 days after infusion with a median length of stay of 5 days. Fourteen patients (19.4%) were admitted within 72 hours of infusion. No patient died of CAR T cell-related toxicity.
Our experience affirms treatment with tisagenlecleucel in the outpatient setting is safe and feasible with close supervision and adequate institutional experience. After infusion, adverse events were manageable and the majority of patients did not require hospitalization.
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