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大 B 细胞淋巴瘤患者 CD19 靶向 CAR-T 细胞治疗后腺病毒诱导的出血性膀胱炎

英文原题:Adenovirus-induced hemorrhagic cystitis after CD19-targeted chimeric antigen receptor T-cell therapy in a patient with large B-cell lymphoma.

查看英文原题

Adenovirus-induced hemorrhagic cystitis after CD19-targeted chimeric antigen receptor T-cell therapy in a patient with large B-cell lymphoma.

PubMed 2023/09/18(内容时间) Immunotherapy Q3 · IF 2.3(JCR 2025)

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中文摘要

靶向CD19的CAR-T 细胞已改变复发/难治性弥漫性大B细胞淋巴瘤的治疗格局。感染是CAR-T 治疗后最常见的并发症之一,多数为细菌感染,但也可能发生病毒感染。腺病毒性出血性膀胱炎是一种罕见感染并发症,通常见于骨髓或实体器官移植后。本文报告一例大B细胞淋巴瘤患者在CAR-T 细胞输注后首月内出现泌尿系统症状,并确诊腺病毒性出血性膀胱炎。结合诊疗经验及文献综述,作者讨论了CAR-T 治疗后这一少见感染的诊断方法和潜在治疗选择。淋巴瘤是一种侵袭性血液肿瘤。CAR-T 疗法是近期开发的一种治疗淋巴瘤及其他血液肿瘤的方法,通过基因改造患者自身T细胞(一种有助于攻击癌细胞的白细胞)发挥作用。CAR-T 治疗疗效显著,但也存在不良事件风险,包括感染。感染可由细菌或病毒引起,并累及多个器官,包括膀胱。血液肿瘤患者发生膀胱感染时,可能出现严重疼痛和出血。此类出血性膀胱感染多由腺病毒或BK病毒引起,通常见于骨髓移植患者,在CAR-T 治疗患者中则较少见。本文报告一例CAR-T 治疗患者发生腺病毒所致出血性膀胱感染,并讨论其罕见感染的诊断和可能治疗方案。

展开英文摘要原文

Chimeric antigen receptor (CAR) T cells targeting CD19 have changed the treatment landscape of patients with relapsed/refractory diffuse large B-cell lymphoma. Infections are one of the most frequent complications after CAR T-cell therapy. Most of these infections are bacterial, although viral infections can also occur in this setting. Adenovirus-induced hemorrhagic cystitis is a rare infectious complication and is usually observed after bone marrow or solid organ transplantation.

Herein we report a case of adenovirus-induced hemorrhagic cystitis in a patient experiencing urinary symptoms within the first month after CAR T-cell infusion. Based on our experience and a literature review, we discuss the diagnostic approach and potential treatment options for this infrequent infection after CAR T-cell therapy. Lymphoma is an aggressive blood cell cancer. A treatment called chimeric antigen receptor (CAR) T-cell therapy has recently been developed for patients with lymphoma and other blood cancers. CAR T-cell therapy is based on the genetic change of the patient's T cells.

T cells are a type of white blood cell, which help to attack cancer. CAR T-cell treatment is very effective, but it also carries a risk of adverse events, including infections. These infections can be caused by bacteria or viruses and can affect several organs, including the bladder. Patients with blood cancers who develop bladder infections can have severe pain and bleeding. These bleeding bladder infections are mostly caused by adenovirus or BK virus and are usually seen in patients who have received a bone marrow transplant.

However, these infections are rarely observed in patients receiving CAR T cells.

We report here a case of bleeding bladder infection caused by adenovirus in a patient receiving CAR T-cell therapy.

We discuss the diagnostic approach and possible treatment options for this rare infection in CAR T-cell patients.

论文信息

作者
Medina I、Carpio C、Ruiz-Camps I、Albasanz-Puig A、Lopez-Godino O、Esperalba J、Beas F、Sanchez-Salinas M
单位
Department of Hematology, Experimental Hematology, Vall d'Hebron Institute of Oncology, University Hospital Vall d'Hebron, 08035, Barcelona, Spain.Spain
文献类型
综述 · 病例报告
期刊
Immunotherapy2023 Nov
原文标识
PubMed 37718888 · DOI 10.2217/imt-2023-0111