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CAR-T 细胞治疗不同 HBV 状态复发/难治性弥漫大 B 细胞淋巴瘤的疗效和安全性:单中心回顾性研究

英文原题:Efficacy and safety of chimeric antigen receptor T cell therapy in relapsed/refractory diffuse large B-cell lymphoma with different HBV status: a retrospective study from a single center.

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Efficacy and safety of chimeric antigen receptor T cell therapy in relapsed/refractory diffuse large B-cell lymphoma with different HBV status: a retrospective study from a single center.

PubMed 2023/05/24(内容时间) Front Immunol Q1 · IF 7(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

研究概要

CAR-T 治疗有效,在适当监测和抗病毒预防下可安全用于合并 HBV 感染的 r/r DLBCL。

研究思路结论见上方概要

CAR-T 细胞治疗是复发/难治性(r/r)弥漫大B细胞淋巴瘤(DLBCL)的有效挽救治疗,但乙型肝炎病毒(HBV)感染的影响尚未被研究。

本研究纳入并分析了在苏州大学附属第一医院接受 CAR-T 治疗的 51 例 r/r DLBCL 患者。CAR-T 治疗的总体缓解率和完全缓解率(CR)分别为 74.5% 和 39.2%。CAR-T 后中位随访时间为 21.1 个月,36 个月总生存期(OS)率和无进展生存期(PFS)率分别为 43.4% 和 28.7%。这些患者被分为三组,包括慢性 HBV 感染组(n=6)、既往 HBV 感染组(n=25)和非 HBV 感染组(n=20)。HBV 感染组的骨髓受累显著更高(P <0.001),CAR-T 治疗前的其他基本特征具有可比性。亚组分析显示,HBV 感染状态不影响 CAR-T 治疗的 CR 率、OS 或 PFS 疗效,三组之间 CAR-T 相关毒性无显著差异。仅 1 例合并慢性 HBV 感染的肝硬化患者出现 HBV 再激活。

展开英文摘要原文

Chimeric antigen receptor T cell (CAR-T) therapy is an effective salvage treatment in relapsed or refractory(r/r) diffuse large B-cell lymphoma (DLBCL), but the impact of hepatitis B virus (HBV) infection has not been studied. METHODS AND RESULTS: Here, 51 patients with r/r DLBCL receiving CAR-T therapy were enrolled and analyzed at the First Affiliated Hospital of Soochow University. The overall response rate and the complete remission rate (CR) of CAR-T therapy were 74.5% and 39.2%, respectively. With a median follow-up of 21.1 months after CAR-T, the probabilities of overall survival (OS) and progression-free survival (PFS) at 36 months were 43.4% and 28.7%, respectively. These patients were divided into three cohorts including chronic HBV infection group (n=6), resolved HBV infection group (n=25) and non-HBV infection group (n=20). Bone marrow involvement was significantly higher in the HBV infection group( P <0.001), other basic characteristics before CAR-T therapy were comparable. Subgroup analysis showed that HBV infection status did not affect the efficacy of CAR-T therapy in CR rate, OS or PFS, and there was no significant difference in CAR-T related toxicities between three cohorts. Only one cirrhosis patient with chronic HBV infection experienced HBV reactivation.

CAR-T therapy was effective and can be used safely in r/r DLBCL with HBV infection under proper monitoring and antiviral prophylaxis.

论文信息

作者
Kong D、Ping N、Gao X、Zou R、Wang P、Wu D、Jin Z、Qu C
单位
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.China
文献类型
非美国政府资助研究
期刊
Frontiers in immunology2023
原文标识
PubMed 37292195 · DOI 10.3389/fimmu.2023.1200748