肿瘤细胞治疗研究
英文原题：Intrathecal CAR-NK cells infusion for isolated CNS relapse after allogeneic stem cell transplantation: case report.
IT CAR-NK 细胞输注对中枢神经系统复发患者是一种潜在可行且有效的选择，且神经毒性有限。
一名24岁男性T细胞急性淋巴细胞白血病患者伴中枢神经系统（CNS）受累，接受同胞异基因干细胞移植（allo-SCT）。移植后早期出现孤立性CNS复发，而大剂量全身化疗、鞘内三联药物输注及鞘内供者淋巴细胞输注（DLI）均显示疗效。我们进行了鞘内输注脐带血来源、靶向CD7的CAR-NK细胞，这种治疗此前尚无报道。输注后检测细胞因子发现，脑脊液中干扰素、白细胞介素6和白细胞介素8升高。患者短时间内出现高热、头痛、恶心、呕吐和伴失禁的脊髓横贯性损害；与此同时，眼睑下垂和视物模糊完全改善。CAR-NK细胞鞘内输注9个多月后，患者骨髓仍令人鼓舞地保持完全缓解及完全供者嵌合。总之，对于CNS复发患者，鞘内输注CAR-NK细胞可能是一种可行有效的治疗选择，神经系统毒性有限。
A 24-year-old man with central nervous system (CNS) involvement of T-cell lineage acute lymphoblastic leukemia received sibling allogeneic stem cell transplantation (allo-SCT). He developed isolated CNS relapse early post-SCT, while high-dose systemic chemotherapy, intrathecal (IT) triple infusion and IT donor lymphocytes infusion (DLI) all demonstrated effectiveness. We performed IT umbilical cord blood-derived CAR-NK (target CD7) cells infusion, which was not previously reported. After infusion, detection of cytokines revealed that interferon- , interleukin-6 and interleukin-8 increased in CSF. He developed high fever, headache, nausea, vomiting and a spinal cord transection with incontinence in a short time, whereas the ptosis and blurred vision improved completely. The bone marrow remained encouragingly complete remission and complete donor chimerism over 9 months after IT CAR-NK cells infusion. In conclusion, IT CAR-NK cells infusion is a potentially feasible and effective option for patients with CNS relapse, with limited neurological toxicity.
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