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:Case Report: Clinical and Serological Hallmarks of Cytokine Release Syndrome in a Canine B Cell Lymphoma Patient Treated With Autologous CAR-T Cells.
Case Report: Clinical and Serological Hallmarks of Cytokine Release Syndrome in a Canine B Cell Lymphoma Patient Treated With Autologous CAR-T Cells.
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本病例报告中记录的观察结果与犬类患者接受 CAR-T 治疗后发生细胞因子释放综合征一致。
CAR-T(CAR-T)细胞已改变人类B细胞恶性肿瘤治疗。随着CAR-T 疗法应用,出现了特异性且有时严重的毒性,其中最常报告的是细胞因子释放综合征(CRS)。犬自然发生肿瘤且处于免疫功能完整环境,为进一步研究CAR-T 疗法活性和相关毒性提供了独特的转化医学机会。尽管犬肿瘤学已有多项过继细胞疗法(ACT)试验报告,且另有多项正在开展,但犬癌症患者CRS尚未得到全面描述。病例报告:我们介绍一只接受自体CAR-T 治疗复发性B细胞淋巴瘤的犬,其治疗后第3天出现嗜睡和发热,并发生临床和血清学变化。多重血清细胞因子分析显示,在体内CAR-T 水平达到峰值时或稍后,涉及人类CRS的关键细胞因子IL-6、MCP-1、IFN-γ和IL-10升高。
本病例观察与犬接受CAR-T 治疗后发生CRS相符。犬是研究CRS病理生理机制以及在复杂、自然演化的免疫系统中临床前筛选预防和治疗这一危及生命疾病新疗法的有力模型。
Chimeric antigen receptor-T (CAR-T) cells have transformed the treatment of human B cell malignancies. With the advent of CAR-T therapy, specific and in some cases severe toxicities have been documented with cytokine release syndrome (CRS) being the most frequently reported. As dogs develop tumors spontaneously and in an immunocompetent setting, they provide a unique translational opportunity to further investigate the activity and toxicities associated with CAR-T therapy. Although various adoptive cellular therapy (ACT) trials have been documented and several more are ongoing in canine oncology, CRS has not been comprehensively described in canine cancer patients. CASE PRESENTATION: Here we present the clinical and serologic changes in a dog treated with autologous CAR-T for relapsed B cell lymphoma that presented with lethargy and fever 3 days following CAR-T. Multiplexed serum cytokine profiling revealed increases in key cytokines implicated in human CRS including IL-6, MCP-1, IFN and IL-10 at or shortly after peak CAR-T levels in vivo .
The observations noted in this case report are consistent with CRS development following CAR-T therapy in a canine patient. The dog represents a compelling model to study the pathophysiology of CRS and pre-clinically screen novel therapeutics to prevent and treat this life-threatening condition in the setting of a complex and naturally evolved immune system.
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