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
英文原题:Cytopenia after CAR‑T cell therapy: Analysis of 63 patients with relapsed and refractory B‑cell non‑Hodgkin lymphoma.
Cytopenia after CAR‑T cell therapy: Analysis of 63 patients with relapsed and refractory B‑cell non‑Hodgkin lymphoma.
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本研究旨在确定接受CAR-T 细胞治疗的复发难治性 B 细胞非霍奇金淋巴瘤(B-NHL)患者中血细胞减少的临床特征。因此,回顾性选取 2017 年 3 月至 2021 年 10 月期间接受 CAR-T 治疗的 63 例复发难治性 B-NHL 患者进行分析。3 级中性粒细胞减少、贫血和血小板减少分别发生于 48 例(76.19%)、16 例(25.39%)和 15 例(23.80%)患者。多因素分析结果显示,基线绝对中性粒细胞计数(ANC)和血红蛋白浓度是 3 级血细胞减少的独立危险因素。共有 3 例患者早期死亡,因此被排除在本研究之外。
此外,在输注后第 +28 天检查细胞恢复情况;21 例患者(35%)血细胞减少未恢复,39 例患者(65%)恢复。多因素分析显示,基线 ANC <2.29 10 9 /l、基线血红蛋白 <114.50 g/l 和基线 IL-6 >21.43 pg/l 是影响血细胞恢复的独立危险因素。
总之,复发难治性 B-NHL 患者在 CAR-T 细胞治疗后 3 级血液学毒性发生率升高,而基线血细胞和 IL-6 水平是血细胞恢复的独立危险因素。
The present study aimed to determine the clinical characteristics of cytopenia in patients with relapsed and refractory B-cell non-Hodgkin lymphoma (B-NHL) who were treated with chimeric antigen receptor T-cell (CAR-T) therapy.
Thus, a total of 63 patients with relapsed and refractory B-NHL who underwent CAR-T therapy between March 2017 and October 2021 were retrospectively selected for analysis. Neutropenia, anemia and thrombocytopenia at grade 3 occurred in 48 (76. 19%), 16 (25. 39%) and 15 (23.
80%) cases, respectively. The results of a multivariate analysis demonstrated that the baseline absolute neutrophil count (ANC) and hemoglobin concentration were independent risk factors for grade 3 cytopenia. A total of 3 patients died early and were therefore excluded from the present study.
Furthermore, cell recovery was examined at day +28 after infusion; 21 patients (35%) did not recover from cytopenia and 39 patients (65%) recovered. A multivariate analysis demonstrated that the baseline ANC <2. 29 10 9 /l, baseline hemoglobin <114. 50 g/l and baseline IL-6 >21. 43 pg/l were independent risk factors affecting hemocyte recovery.
In conclusion, patients with relapsed and refractory B-NHL exhibited an increased incidence of grade 3 hematologic toxicity following CAR-T cell therapy, while baseline blood cell and IL-6 levels are independent risk factors for hemocyte recovery.
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