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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Respiratory Viral Infections in Recipients of Cellular Therapies: A Review of Incidence, Outcomes, Treatment, and Prevention.
Respiratory Viral Infections in Recipients of Cellular Therapies: A Review of Incidence, Outcomes, Treatment, and Prevention.
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呼吸道病毒感染(RVI)对免疫功能低下患者具有重要临床影响,是血液恶性肿瘤患者及造血细胞移植受者发病和死亡的重要原因。类似地,接受CD19 CAR-T、NK细胞疗法及基因改造TCR细胞治疗者也易发生RVI,并可能进展为下呼吸道感染。过继细胞治疗受者易感性升高,源于既往化疗(如淋巴细胞清除预处理)、基础B细胞恶性肿瘤、免疫相关毒性及继发的长期严重低丙种球蛋白血症。RVI累积风险因素会造成近期和长期后果。本综述总结过继细胞治疗受者特有RVI的发病机制、流行病学及临床特点,常见RVI预防和治疗选择,以及适宜感染控制与预防策略。
Respiratory viral infections (RVIs) are of major clinical importance in immunocompromised patients and represent a substantial cause of morbidity and mortality in patients with hematologic malignancies and those who have undergone hematopoietic cell transplantation. Similarly, patients receiving immunotherapy with CD19-targeted chimeric antigen receptor-modified T cells, natural killer cells, and genetically modified T-cell receptors are susceptible to RVIs and progression to lower respiratory tract infections.
In adoptive cellular therapy recipients, this enhanced susceptibility to RVIs results from previous chemotherapy regimens such as lymphocyte-depleting chemotherapy conditioning regimens, underlying B-cell malignancies, immune-related toxicities, and secondary prolonged, profound hypogammaglobulinemia.
The aggregated risk factors for RVIs have both immediate and long-term consequences. This review summarizes the current literature on the pathogenesis, epidemiology, and clinical aspects of RVIs that are unique to recipients of adoptive cellular therapy, the preventive and therapeutic options for common RVIs, and appropriate infection control and preventive strategies.
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