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
英文原题:Long-term efficacy of CAR-T cell therapy for patients with relapsed/refractory B cell non-Hodgkin lymphoma.
Long-term efficacy of CAR-T cell therapy for patients with relapsed/refractory B cell non-Hodgkin lymphoma.
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CAR-T 细胞疗法对复发/难治性 B-NHL 患者有效,不良反应可控。
评估嵌合抗原受体(CAR)T细胞疗法治疗复发/难治性B细胞非霍奇金淋巴瘤(B-NHL)的长期疗效。
分析2016年6月至2020年6月浙江大学医学院附属第一医院骨髓移植中心收治的27例接受CAR-T 细胞治疗的复发/难治性B-NHL患者的临床资料。随访至2022年2月1日。采用Kaplan-Meier法评估总生存率、无进展生存期(PFS)率,并记录不良反应。
27例患者的中位随访时间为32(1,56)个月。总有效率为85.2%(23/27),完全缓解率为63.0%(17/27),部分缓解率为22.2%(6/27)。3年总生存率为(50.0±10.1)%,PFS率为(44.4±9.6)%。CAR-T 细胞治疗后,完全缓解组患者的总生存期和PFS均显著优于非完全缓解组[总生存率:(66.9±12.7)% vs.(20.0±12.6)%,P=0.01;PFS率:(64.7±11.6)% vs.(10.0±9.5)%,P<0.01]。CD19靶向与CD19/CD22双靶向CAR-T 细胞治疗的总生存率和PFS率差异均无统计学意义(均P>0.05)。92.6%(25/27)的患者发生细胞因子释放综合征,88.9%(24/27)的患者发生-级骨髓抑制。其他不良反应包括免疫效应细胞相关神经毒性综合征、乙型肝炎病毒激活以及肺部或胃肠道感染。未发生远期不良反应。
To evaluate the long-term efficacy of chimeric antigen receptor (CAR) T cell therapy in treatment of relapsed/refractory B cell non-Hodgkin lymphoma (B-NHL).
Clinical data of 27 patients with relapsed/refractory B-NHL treated with CAR-T cell in Bone Marrow Transplantation Center, the First Affiliated Hospital of Zhejiang University School of Medicine from June 2016 to June 2020 were analyzed. Patients were followed up to February 1, 2022. The overall survival rate, progression free survival (PFS) rate were evaluated by Kaplan-Meier analysis, and the adverse reactions were recorded.
The median follow-up time of 27 patients was 32 (1, 56) months. The total response rate was 85.2% (23/27), the complete response rate was 63.0% (17/27), and the partial response rate was 22.2% (6/27). The 3-year overall survival rate was (50.0 10.1)%, and the PFS rate was (44.4 9.6)%. After CAR-T cell therapy, the overall survival and PFS of patients in the complete response group were significantly better than those in the non-complete response group [overall survival rate: (66.9 12.7)% vs. (20.0 12.6)%, P =0.01; PFS rate: (64.7 11.6)% vs. (10.0 9.5)%, P <0.01]. There was no significant difference in overall survival rate and PFS rate between CD19 targeted and CD19/CD22 dual-targeted CAR-T cell therapy (both P >0.05). Cytokine release syndrome developed in 92.6% (25/27) of patients, and 88.9% (24/27) of patients had grade - myelosuppression. Other adverse reactions include immune effector cell-associated neurotoxicity syndrome, hepatitis B virus activation, and lung or gastrointestinal infections. No long-term adverse reactions occurred.
CAR-T cell therapy is effective for patients with relapsed/refractory B-NHL, and the adverse reactions are controllable. The patients who obtain complete response after CAR-T cell therapy or survive for one year after therapy may have better long-term survival.
: To evaluate the long-term efficacy of chimeric antigen receptor (CAR) T cell therapy in treatment of relapsed/refractory B cell non-Hodgkin lymphoma (B-NHL).
: Clinical data of 27 patients with relapsed/refractory B-NHL treated with CAR-T cell in Bone Marrow Transplantation Center, the First Affiliated Hospital of Zhejiang University School of Medicine from June 2016 to June 2020 were analyzed. Patients were followed up to February 1, 2022. The overall survival rate, progression free survival (PFS) rate were evaluated by Kaplan-Meier analysis, and the adverse reactions were recorded.
: The median follow-up time of 27 patients was 32 (1, 56) months. The total response rate was 85.2% (23/27), the complete response rate was 63.0% (17/27), and the partial response rate was 22.2% (6/27). The 3-year overall survival rate was (50.0 10.1)%, and the PFS rate was (44.4 9.6)%. After CAR-T cell therapy, the overall survival and PFS of patients in the complete response group were significantly better than those in the non-complete response group [overall survival rate: (66.9 12.7)% vs. (20.0 12.6)%, P =0.01; PFS rate: (64.7 11.6)% vs. (10.0 9.5)%, P <0.01]. There was no significant difference in overall survival rate and PFS rate between CD19 targeted and CD19/CD22 dual-targeted CAR-T cell therapy (both P >0.05). Cytokine release syndrome developed in 92.6% (25/27) of patients, and 88.9% (24/27) of patients had grade myelosuppression. Other adverse reactions include immune effector cell-associated neurotoxicity syndrome, hepatitis B virus activation, and lung or gastrointestinal infections. No long-term adverse reactions occurred.
: CAR-T cell therapy is effective for patients with relapsed/refractory B-NHL, and the adverse reactions are controllable. The patients who obtain complete response after CAR-T cell therapy or survive for one year after therapy may have better long-term survival.
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