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
病例报告：严重肾功能损害患者淋巴细胞清除后序贯 Idecabtagen vicleucel CAR-T 细胞治疗
英文原题：Case Report: Lymphodepletion followed by CAR-T cell therapy with Idecabtagen vicleucel in a patient with severe renal impairment.
查看英文原题
Case Report: Lymphodepletion followed by CAR-T cell therapy with Idecabtagen vicleucel in a patient with severe renal impairment.
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中文摘要
急性肾损伤和慢性肾病在多发性骨髓瘤患者中较常见。氟达拉滨是CAR-T 治疗前淋巴细胞清除预处理方案的一部分，主要经肾脏清除；对于肾小球滤过率低于30 mL/min/1.73 m²的重度肾功能损害患者，通常不建议使用。本病例中，一名58岁女性患骨髓瘤并有重度肾功能损害，在输注Idecabtagene vicleucel前的淋巴细胞清除方案中接受氟达拉滨。氟达拉滨减量至15 mg/m²，环磷酰胺剂量为300 mg/m²，随后使用较大滤器（FX-100）进行6小时血液透析。治疗耐受良好，CAR-T 细胞扩增出色，并获得完全缓解；截至报告时缓解已持续超过12个月。
展开英文摘要原文
Acute kidney injury and chronic kidney disease is common in multiple myeloma. Fludarabine which is part of lymphodepletion before CAR-T cell therapy is renally eliminated and its use is not recommended for patients with severe renal impairment defined as a glomerular filtration rate below 30ml/min/1. 73m 2 .
We administered fludarabine to a 58-year-old female patient with myeloma-associated severe renal impairment as part of lymphodepletion before Idecabtagen vicleucel infusion. Fludarabine was administered in reduced dose (15mg/m 2 ) and cyclophosphamide with a dose of 300mg/m 2 followed by hemodialysis over six hours using a larger filter (FX-100). The therapy was well tolerated with excellent CAR-T cell expansion and complete remission which is ongoing now beyond 12 months.
论文信息
- 作者
- Marquard F、Langebrake C、Janson D、Mahmud M、Dadkhah A、Kröger N、Ayuk F
- 单位
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Germany
- 文献类型
- 病例报告
- 期刊
- Frontiers in oncology2023
- 原文标识
- PubMed 38033500 · DOI 10.3389/fonc.2023.1288764
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