决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Effectiveness of tixagevimab/cilgavimab in patients with hematological malignancies as a pre-exposure prophylaxis to prevent severe COVID-19: a Czech retrospective multicenter study.
在该队列的 606 例患者中,96 例(16%)感染了 COVID-19,中位时间为 Evusheld 给药后 98.5 天。
尽管严重急性呼吸综合征冠状病毒2(SARS-CoV-2)奥密克戎变异株毒力较低,但仍对免疫功能低下患者构成显著威胁。本研究开展回顾性多中心研究,评估对血液系统恶性肿瘤成年患者进行替沙格韦单抗/西加韦单抗(Evusheld)暴露前预防、随访6个月以预防重症COVID-19的效果。606例患者中,96例(16%)感染COVID-19,发生于Evusheld给药后中位98.5天。75%的患者COVID-19无症状或病情较轻;SARS-CoV-2检测阳性者中仅25%需要住院。2例(2%)直接死于COVID-19,另有1例(1%)死因与COVID-19有关。每个队列中有8例患者(1.3%)经历与Evusheld相关的不良事件,多为1级且可逆。研究发现,完成疫苗接种或血清学转阳与COVID-19感染风险降低无关。既往接受抗CD20单克隆抗体治疗与更高COVID-19发生率相关,而既往抗CD38单克隆抗体治疗则无此关联;接受造血干细胞移植或CAR-T细胞治疗者亦未见该关联。其他合并症与COVID-19病情加重无关。结果支持不断增加的证据,即Evusheld可有效预防血液系统恶性肿瘤患者重症COVID-19。
Despite lower virulence, the omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) still poses a relevant threat for immunocompromised patients. A retrospective multicentric study was conducted to evaluate the efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) with a 6-month follow-up for preventing severe COVID-19 in adult patients with hematology malignancy. Among the 606 patients in the cohort, 96 (16%) contracted COVID-19 with a median of 98.5 days after Evusheld administration. A total of 75% of patients had asymptomatic or mild severity of COVID-19, while just 25% of patients with SARS-CoV-2 positivity had to be hospitalized. Two patients (2%) died directly, and one patient (1%) in association with COVID-19. Eight patients (1.3%) of every cohort experienced adverse events related to Evusheld, mostly grade 1 and of reversible character. It was found that complete vaccination status or positive seroconversion was not associated with lower risk of COVID-19 infection. Previous treatment with an anti-CD20 monoclonal antibody was associated with higher rates of COVID-19, while previous treatment with anti-CD38 monoclonal antibody was not, as was the case for recipients of hematopoietic stem cell transplantation or CAR-T cell therapy. Presence of other comorbidities was not associated with more severe COVID-19. The results support the growing evidence for Evusheld's efficacy against severe COVID-19 in patients with hematology malignancies.
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