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.
CAR-T（CAR-T）细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
axicabtagene ciloleucel 和 brexucabtagene autoleucel 后类似噬血细胞性淋巴组织细胞增生症的过度炎症综合征
英文原题：Hyperinflammatory syndrome resembling haemophagocytic lymphohistiocytosis following axicabtagene ciloleucel and brexucabtagene autoleucel.
查看英文原题
Hyperinflammatory syndrome resembling haemophagocytic lymphohistiocytosis following axicabtagene ciloleucel and brexucabtagene autoleucel.
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中文摘要
CAR-T 细胞治疗后出现类似噬血细胞性淋巴组织细胞增多症（HLH）的毒性（CAR-HLH）正日益受到关注，但已发表数据有限，识别标准也不明确。本文报告3例CAR-HLH患者，其中2例接受brexucabtagene autoleucel，1例接受axicabtagene ciloleucel。三例患者均在细胞因子释放综合征后出现发热、反复或加重的血细胞减少、铁蛋白血症、可溶性白细胞介素2受体升高、低纤维蛋白原血症、高甘油三酯血症、肝转氨酶升高，以及C反应蛋白和IL-6水平下降。分别使用阿那白滞素（2例）和芦可替尼（1例）治疗后，患者临床情况有所改善。本病例系列有助于及早识别CAR-HLH并尽早开始可能挽救生命的治疗。
展开英文摘要原文
Haemophagocytic lymphohistiocytosis-like toxicity following chimeric antigen receptor T cells (CAR-HLH) is being increasingly recognized, while published data are limited and criteria for recognition are elusive.
We describe three patients who developed CAR-HLH after infusion of brexucabtagene autoleucel (n = 2) or axicabtagene ciloleucel (n = 1). All three patients presented following cytokine release syndrome, with fever, recurrent or worsening cytopenias, hyperferritinaemia, elevated soluble interleukin (IL)-2 receptor, hypofibrinogenaemia, hypertriglyceridaemia, elevated liver transaminases, and decreasing C-reactive protein and IL-6. Clinical improvement following treatment with anakinra (n = 2) and ruxolitinib (n = 1) was observed.
Our report offers an opportunity for prompt recognition and initiation of potentially life-saving treatment for CAR-HLH.
论文信息
- 作者
- Porter TJ、Lazarevic A、Ziggas JE、Fuchs E、Kim K、Byrnes H、Luznik L、Bolaños-Meade J
- 第一作者单位
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland, USA.United States
- 通讯作者单位
- Division of Hematological Malignancies and Bone Marrow Transplantation, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA.United States
- 期刊
- British journal of haematology2022 Dec
- 原文标识
- PubMed 36111395 · DOI 10.1111/bjh.18454
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