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
接受 CAR-T 治疗的血液病患者中的感染：一项系统综述与荟萃分析
英文原题：Infections in haematology patients treated with CAR-T therapies: A systematic review and meta-analysis.
查看英文原题
Infections in haematology patients treated with CAR-T therapies: A systematic review and meta-analysis.
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中文摘要
本研究在PROSPERO注册（CRD42022346462），针对接受CAR-T 疗法治疗血液系统恶性肿瘤的成年患者，开展任何级别感染的系统综述和荟萃分析。采用随机效应模型合并感染发生率，并以Cochran Q检验评估异质性。主要结局分析纳入33项研究、共2,678例患者。任何级别感染发生率为40%（95% CI 0.33–0.48），感染事件中25%为重度感染（95% CI 0.16–0.34）。迟发感染与早期感染同样常见（IRR=0.86，95% CI 0.38–1.98）。骨髓瘤患者任何级别感染、细菌感染和病毒感染发生率最高，分别为57%、37%和28%。非霍奇金淋巴瘤患者更常发生迟发感染。在采用抗酵母菌预防的研究中，侵袭性念珠菌病/酵母菌感染合并发生率为2%。综上，本综述发现CAR-T 治疗后任何级别感染发生率较高，重度感染发生率中等，且骨髓瘤是感染高风险血液肿瘤亚群。
展开英文摘要原文
A registered (PROSPERO - CRD42022346462) systematic review and meta-analysis was conducted of all-grade infections amongst adult patients receiving CAR-T therapy for haematological malignancy. Meta-analysis of pooled incidence, using random effects model, was conducted. Cochran's Q test examined heterogeneity. 2678 patients across 33 studies were included in the primary outcome. Forty-percent of patients (95% CI: 0. 33 - 0. 48) experienced an infection of any grade. Twenty-five percent of infection events (95% CI: 0. 16 - 0.
34) were severe. Late infections were as common as early infections (IRR = 0. 86, 95% CI: 0. 38 - 1. 98). All-grade infections, bacterial and viral infections were highest in myeloma patients at 57%, 37% and 28% respectively. Patients with NHL more commonly experienced late infections. Pooled rate of invasive candidiasis/yeast infections was 2% in studies utilizing anti-yeast prophylaxis. This review identified a high rate of all-grade infections, moderate rate of severe infections, and myeloma as a high-risk haematological group.
论文信息
- 作者
- Reynolds GK、Sim B、Spelman T、Thomas A、Longhitano A、Anderson MA、Thursky K、Slavin M
- 单位
- Dpartment of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia; National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia. Electronic address: gkreynolds@student.unimelb.edu.au.Australia
- 文献类型
- 荟萃分析 · 系统综述
- 期刊
- Critical reviews in oncology/hematology2023 Dec
- 原文标识
- PubMed 37739146 · DOI 10.1016/j.critrevonc.2023.104134