决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:HBV reactivation in patients with chronic or resolved HBV infection following BCMA-targeted CAR-T cell therapy.
HBV reactivation in patients with chronic or resolved HBV infection following BCMA-targeted CAR-T cell therapy.
在本研究中,我们回顾性分析了 99 例接受 BCMA 靶向 CAR-T 细胞治疗的复发/难治性 MM 患者,其中 7 例(7.1%)为慢性 HBV 感染,43 例(43.4%)为既往 HBV 感染已消退,其余 49 例(49.49%)未感染 HBV。
靶向B细胞成熟抗原(BCMA)的CAR-T用于复发或难治性多发性骨髓瘤(MM),但慢性或既往乙肝病毒(HBV)感染患者接受该疗法的安全性和疗效仍受关注。本研究回顾分析99例接受BCMA CAR-T的患者,其中7例慢性HBV感染、43例既往感染已恢复、49例无HBV感染。各组治疗前特征相近。不同HBV血清学状态患者治疗后的肝功能、细胞因子水平、CAR-T扩增和CRS分级无差异;慢性或既往HBV感染也未影响临床应答、PFS或OS。4例(4.04%)发生HBV再激活,其中既往感染者3例(6.98%),慢性感染者1例(14.29%);其中2例出现重症肝炎。再激活前后4例患者均观察到血清IgG下降及ALT、AST和总胆红素升高。
B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor-T cell (CAR-T) therapy is used for refractory or relapsed multiple myeloma (r/r MM). Concern of the safety and efficacy of CAR-T cell therapy in patients with chronic or resolved HBV infection is raised. In this study, we retrospectively reviewed 99 patients with r/r MM treated with BCMA-targeted CAR-T cell therapy, of which 7 (7.1%) patients had chronic HBV infection, 43 (43.4%) with resolved HBV infection, and the remaining 49 (49.49%) HBV-uninfected. Patients' characteristics before CAR-T cell administration were comparable in different status of HBV infection. Patients' liver function, cytokine levels, CAR-T cell expansion and cytokine release syndrome (CRS) grade after CAR-T cell therapy did not differ in different HBV serologic status. Furthermore, chronic HBV infection or resolved HBV infection did not affect clinical response, progress-free survival (PFS), or overall survival (OS). Four (4.04%) patients experienced HBV reactivation, 3 (6.98%) with resolved HBV infection, and 1 (14.29%) chronic HBV infection. Of 4 patients with HBV reactivation, 2 cases (50%) of severe hepatitis were noted and reported. Drops of serum IgG and elevation of alanine aminotransferase (ALT), alanine aminotransferase (AST), total bilirubin (TB) were observed in all four patients around the date of HBV reactivation.
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