不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Severe lympho-depletion, abrogated thymopoiesis and systemic EBV positive T-cell lymphoma of childhood, a case.
Severe lympho-depletion, abrogated thymopoiesis and systemic EBV positive T-cell lymphoma of childhood, a case.
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EBV相关的T细胞和NK细胞淋巴增殖性疾病是致死性的,在白种人中极为罕见。我们扩展了与第二例欧洲病例(19岁,既往健康,白种人男孩)系统性EBV阳性儿童期T细胞淋巴瘤相关的临床、免疫学和组发生学特征。我们报告了新的发现:继发于严重EBV激活和过度免疫激活的严重淋巴细胞耗竭和胸腺生成中止。与第一例欧洲病例相似,我们也检测到原癌基因FYN中的体细胞错义变异。然而,在第一例欧洲患者中,FYN变异等位基因频率(VAF)为10%,患者仅经历中度白细胞减少,而在我们的病例中,VAF为48%,患者经历了严重白细胞减少和淋巴细胞减少。这可能提示这些FYN变异在驱动过度T细胞激活中具有致病作用。如果得到证实,FYN可能成为这种致命疾病未来治疗的靶点。
Epstein-Barr virus (EBV) associated T-cell and NK-cell lymphoproliferative diseases are lethal and extremely rare in Caucasians.
We expand on the clinical, immunological and histogenetic characteristics associated with this second European case (19 years old, previously healthy, Caucasian boy) of systemic EBV positive T-cell lymphoma of childhood.
We report, as novel findings, severe lympho-depletion and abrogation of thymopoiesis secondary to severe EBV activation and excessive immune activation. Similar to the first European case, we also detected a somatic missense variant in the proto-oncogene FYN .
In the first European patient however, the FYN variant allele frequency (VAF) was 10% and the patient only experienced moderate leukopenia, whereas in our case, the VAF was 48% and the patient experienced severe leukopenia and lymphopenia. This could suggest a pathogenic role of these FYN variants in driving excessive T cell activation. If confirmed, FYN might become target in future treatments of this fatal disorder.
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