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
接受抗 CD19 CAR-T 细胞治疗的复发/难治性淋巴瘤患者疾病进展与生存的临床及影像学预测因素
英文原题：Clinical and Radiographic Predictors of Progression and Survival in Relapsed/Refractory Lymphoma Patients Receiving Anti-CD19 CAR T-cell Therapy.
查看英文原题
Clinical and Radiographic Predictors of Progression and Survival in Relapsed/Refractory Lymphoma Patients Receiving Anti-CD19 CAR T-cell Therapy.
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研究概要
临床变量可识别出 CAR-T 细胞治疗后存在疾病进展和总生存期不佳风险的复发/难治性淋巴瘤患者。
中文摘要
方法
回顾性分析59例接受抗CD19 CAR-T 治疗的R/R B细胞非霍奇金淋巴瘤患者。识别无进展生存期（PFS）和总生存期（OS）的危险因素，并通过逐步选择法构建1年PFS和OS的多变量逻辑回归模型。采用最终多变量逻辑回归模型估算受试者工作特征曲线下面积（AUROC）。
结果
中位随访25.6个月时，中位OS尚未达到，中位PFS为5.7个月。IV期疾病可预测第365天疾病进展（优势比[OR]9.335，P=0.025），AUC为0.7922（P<0.001）。预测第365天死亡的因素包括国际预后指数（IPI；OR 2.828，P=0.014）、采集时绝对淋巴细胞计数（ALC）低于0.50（OR 0.183，P=0.043）、CRP高于11（OR 6.177，P=0.019）及使用托珠单抗（OR 0.062，P=0.005），AUC为0.8626（P<0.001）。
结论
临床变量可识别CAR-T 治疗后有进展风险和总生存期较差的R/R淋巴瘤患者。IPI、CRP、ALC和托珠单抗给药可能是生存预测因素。
展开英文摘要原文
METHODS
We conducted a retrospective review of 59 R/R B-cell non-Hodgkin lymphoma patients who received anti-CD19 CAR T-cell therapy. Risk factors for progression free survival (PFS) and overall survival (OS) were identified and multivariate logistic regression models for PFS and OS at 1 year were created using stepwise selection. The final multivariate logistic regression models were used to estimate the area under the receiver operating curve (AUROC).
RESULTS
At median follow up of 25.6 months, median overall survival was not reached, and median progression free survival was 5.7 months. Stage IV disease (odds ratio (OR) 9.335, P = .025) was identified as a predictive variable for progression at day 365 with an AUC of 0.7922 (P < .001). IPI (OR 2.828, P = .014), ALC 0.50 at collection (OR 0.183, P = .043), CRP 11 (OR 6.177, P = .019), and tocilizumab administration (OR 0.062, P = .005) as predictors for death at day 365 with an AUC 0.8626 (P < .001).
CONCLUSION
Clinical variables identify R/R lymphoma patients who are at risk for progression and poor overall survival after CAR T-cell therapy. IPI, CRP, ALC, and tocilizumab administration may be predictors of survival.
论文信息
- 作者
- Jodon G、Colton MD、Abbott D、Cai A、Haverkos B、Morgan R、Kamdar M
- 单位
- Division of Hematology, Hematologic Malignancies and Stem Cell Transplantation, University of Colorado Cancer Center, Aurora, CO. Electronic address: gray.jodon@cuanschutz.edu.
- 期刊
- Clinical lymphoma, myeloma & leukemia2023 Jan
- 原文标识
- PubMed 36335021 · DOI 10.1016/j.clml.2022.09.009