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
血栓弹力图在预测血液恶性肿瘤患者嵌合抗原受体 (CAR)-T 细胞治疗后出血严重程度中的应用
英文原题：Application of thromboelastography to predict the severity of bleeding after chimeric antigen receptor (CAR)-T cell therapy in patients with hematological malignancy.
查看英文原题
Application of thromboelastography to predict the severity of bleeding after chimeric antigen receptor (CAR)-T cell therapy in patients with hematological malignancy.
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研究概要
血栓弹力图被认为是出血严重程度的良好预测指标。
中文摘要
目的
分析血栓弹力图对CAR-T 细胞治疗患者出血严重程度的预测价值。
方法
纳入80例复发/难治性血液系统恶性肿瘤患者，分为严重出血组和非严重出血组。在CAR-T 输注当日及输注后第3、7、10、13、17和20天采集血栓弹力图数据。
结果
严重出血组的血小板计数（p<0.007）、最大振幅（p=0.002）和凝血指数（p=0.005）较低，凝血时间较长（p=0.019）。输注后第0至10天，反应时间和凝血时间呈上升趋势，而α角、最大振幅和凝血指数呈下降趋势；第10至20天则相反。单变量及多变量Logistic回归分析显示，输注后第3天最大振幅（MA3；OR=0.9，95% CI 0.84–0.95，p<0.001）和细胞因子释放综合征分级（OR=2.57，95% CI 1.35–5.32，p=0.006）均与出血严重程度显著相关。
结论
血栓弹力图可作为预测出血严重程度的有效指标。
展开英文摘要原文
OBJECTIVES
We aim to analyze the predictive value of thromboelastography on bleeding severity of patients with chimeric antigen receptor (CAR)-T cell therapy.
METHODS
A total of 80 patients with refractory/relapsed hematological malignancy were enrolled and divided into two groups: the severe bleeding group and the non-severe bleeding group. The thromboelastography data was collected on the day of CAR-T infusion and the 3rd, 7th, 10th, 13th, 17th, and 20th day after CAR-T cell infusion.
RESULTS
The patients of the severe bleeding group had lower platelet (p < .007), maximum amplitude (p = .002), coagulation index (p = .005), and longer coagulation time (p = .019). Increasing trend in reaction time and coagulation time and decreasing trend in Alpha, maximum amplitude, and coagulation index on Days 0-10, opposite on Days 10-20. Univariate logistic regression analysis and multivariable logistic regression analysis showed maximum amplitude on the 3rd day after CAR-T cell infusion (MA3) (OR = 0.9; 95% CI = 0.84-0.95; p < .001) and cytokine release syndrome grade (OR = 2.57; 95% CI = 1.35-5.32; p = .006) were significantly associated with high bleeding severity.
CONCLUSIONS
Thromboelastography was considered to be a good predictor of bleeding severity.
论文信息
- 作者
- Chen L、Ding S、Cheng Y、Zhou L、Yan J、Cheng Q、Jin A、Zhou X
- 第一作者单位
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.China
- 通讯作者单位
- Department of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.China
- 期刊
- European journal of haematology2024 Feb
- 原文标识
- PubMed 37698159 · DOI 10.1111/ejh.14099