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
病例报告：抗 CD19 CAR-T 细胞治疗后的侵袭性真菌感染——对抗真菌预防的启示
英文原题：Case Report: Invasive fungal infection after anti-CD19 CAR-T cell therapy. Implication for antifungal prophylaxis.
查看英文原题
Case Report: Invasive fungal infection after anti-CD19 CAR-T cell therapy. Implication for antifungal prophylaxis.
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中文摘要
CAR-T 疗法革新了复发/难治性B细胞恶性肿瘤治疗。由于治疗后免疫抑制，接受该疗法的患者感染发生率增加。中性粒细胞减少期间是否需要抗真菌预防仍待确定。本文报告一名55岁复发/难治性弥漫性大B细胞淋巴瘤患者接受阿基仑赛治疗后的临床结局。患者发生II级细胞因子释放综合征（CRS）和IV级免疫效应细胞相关神经毒性综合征（ICANS），需使用托珠单抗、长期类固醇和阿那白滞素。CAR-T 再输注1个月后发生侵袭性肺曲霉菌病，后经气管袖式肺切除术治愈。患者目前已完全缓解。该病例提示应考虑抗真菌预防；本中心现已将米卡芬净纳入标准预防方案。
展开英文摘要原文
CAR-T therapy has revolutionized the treatment of relapsed/refractory B-cell malignancies. Patients who are receiving such therapy are susceptible to an increased incidence of infections due to post-treatment immunosuppression. The need for antifungal prophylaxis during the period of neutropenia remains to be determined. The clinical outcome of a 55-year-old patient with relapsed/refractory DLBCL who received axicabtagene ciloleucel is described here.
The patient developed CRS grade II and ICANS grade IV requiring tocilizumab, prolonged use of steroids and anakinra. An invasive pulmonary aspergillosis arose after 1 month from CAR-T reinfusion, resolved with tracheal sleeve pneumonectomy. The patient is now in Complete Remission. This case suggests that antifungal prophylaxis should be considered.
We have now included micafungin as a standard prophylaxis in our institution.
论文信息
- 作者
- Pennese E、Salutari P、Carriero L、Restuccia F、De Filippis AF、De Luca G、Giancola R、Guardalupi F
- 单位
- Hematology Unit, Department of Oncology and Hematology, Spirito Santo Hospital, Pescara, Italy.Italy
- 文献类型
- 病例报告 · 非美国政府资助研究
- 期刊
- Frontiers in immunology2023
- 原文标识
- PubMed 37841271 · DOI 10.3389/fimmu.2023.1272798
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