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嵌合抗原受体(CAR)T 细胞治疗的感染并发症

英文原题:Infectious complications of chimeric antigen receptor (CAR) T-cell therapies.

查看英文原题

Infectious complications of chimeric antigen receptor (CAR) T-cell therapies.

PubMed 2023/03/06(内容时间) Semin Hematol Q1 · IF 4.3(JCR 2025)

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中文摘要

CAR-T 细胞彻底改变了多种血液系统恶性肿瘤的治疗。数千名淋巴瘤、急性淋巴细胞白血病和多发性骨髓瘤患者接受了这种“活药物”并获得持久缓解。CAR-T 细胞的治疗定位仍在演变,新一代 CAR 构型、针对实体瘤的 CAR-T 细胞,以及针对人类免疫缺陷病毒和乙型肝炎等慢性感染的 CAR-T 细胞均在研发中。不幸的是,相当一部分 CAR-T 细胞治疗接受者会发生感染。这既与患者自身因素有关,也与治疗相关:治疗需进行淋巴细胞清除(LD),会造成中性粒细胞减少和低丙种球蛋白血症,并必然加重患者免疫抑制。本综述旨在介绍 CAR-T 细胞治疗的感染性并发症,阐明其发生时间进程和风险因素,并提出预防、诊断和管理建议。

展开英文摘要原文

CAR T-cells have revolutionized the treatment of many hematological malignancies. Thousands of patients with lymphoma, acute lymphoblastic leukemia, and multiple myeloma have received this "living medicine" and achieved durable remissions. Their place in therapy continues to evolve, and there is ongoing development of new generation CAR constructs, CAR T-cells against solid tumors and CAR T-cells against chronic infections like human immunodeficiency virus and hepatitis B.

A significant fraction of CAR T-cell recipients, unfortunately, develop infections. This is in part due to factors intrinsic to the patient, but also to the treatment, which requires lymphodepletion (LD), causes neutropenia and hypogammaglobulinemia and necessarily increases the state of immunosuppression of the patient. The goal of this review is to present the infectious complications of CAR T-cell therapy, explain their temporal course and risk factors, and provide recommendations for their prevention, diagnosis, and management.

论文信息

作者
Gea-Banacloche JC
单位
Division of Clinical Research, NIAID, Bethesda, MD; NIH Clinical Center, Bethesda, MD. Electronic address: banacloj@nih.gov.United States
文献类型
综述
期刊
Seminars in hematology2023 Jan
原文标识
PubMed 37080711 · DOI 10.1053/j.seminhematol.2023.02.003