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
CAR-T 细胞治疗可及之前自体移植后复发弥漫大 B 细胞淋巴瘤患者的结局
英文原题：Outcome of Patients with Diffuse Large B-Cell Lymphoma Relapsing after Autologous Transplant before Availability of CAR-T Cell Treatment.
查看英文原题
Outcome of Patients with Diffuse Large B-Cell Lymphoma Relapsing after Autologous Transplant before Availability of CAR-T Cell Treatment.
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研究概要
在 ASCT 后复发/难治的 DLBCL 中，额外治疗可延长 OS，但大多无法阻止死亡。本研究可作为该人群 CAR-T 治疗后新出现结果的参考。
研究思路结论见上方概要
背景
自体干细胞移植（ASCT）联合大剂量化疗被用作复发疾病患者的挽救治疗，或作为化疗敏感的高危DLBCL患者的一线巩固治疗。然而，在CAR-T 细胞治疗出现之前，ASCT后复发DLBCL的预后仍然很差。为了理解这一进展，了解前CAR-T 时代这些患者的结局至关重要。
方法
我们回顾性分析了125例连续接受HDCT/ASCT的DLBCL患者。
结果
中位随访26个月后，OS和PFS分别为65%和55%。53例患者（42%）在ASCT后中位3个月出现复发（32例，60%）或难治性疾病（21例，40%）。81%的复发发生在ASCT后第一年内，其OS为19%，而较晚复发患者末次随访时OS为40%（p=0.0022）。ASCT后r/r疾病患者的OS劣于持续缓解患者（23% versus 96%；p<0.0001）。ASCT后复发且未接受挽救治疗的患者（n=22）OS劣于接受1-4线后续治疗的患者（n=31）（OS 0% versus 39%；中位OS 3 versus 25个月；p<0.0001）。ASCT后复发的患者中有41例（77%）死亡，其中35例死于疾病进展。
展开英文摘要原文
METHODS
We retrospectively analyzed 125 consecutive DLBCL patients who underwent HDCT/ASCT.
RESULTS
After a median follow-up of 26 months, OS and PFS were 65% and 55%. Fifty-three patients (42%) had a relapse (32 patients, 60%) or refractory disease (21 patients, 40%) after a median of 3 months post-ASCT. 81% of relapses occurred within the first year post-ASCT with an OS of 19% versus 40% at the last follow-up in patients with later relapses (p=0.0022). Patients with r/r disease after ASCT had inferior OS compared to patients in ongoing remission (23% versus 96%; p<0.0001). Patients relapsing post-ASCT without salvage therapy (n=22) had worse OS than patients with 1-4 subsequent treatment lines (n=31) (OS 0% versus 39%; median OS 3 versus 25 months; p<0.0001). Forty-one (77%) of patients relapsing after ASCT died, 35 of which due to progression.
CONCLUSIONS
Additional therapies can extend OS but mostly cannot prevent death in DLBCL relapsing/refractory post-ASCT. This study may serve as a reference to emerging results after CAR-T treatment in this population.
论文信息
- 作者
- von Matt S、Bacher U、Banz Y、Taleghani BM、Novak U、Pabst T
- 单位
- Department of Medical Oncology; Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.Switzerland
- 期刊
- Mediterranean journal of hematology and infectious diseases2023
- 原文标识
- PubMed 37180203 · DOI 10.4084/MJHID.2023.025
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