肿瘤细胞治疗研究
英文原题：T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy.
T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy.
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我们报告了 1 例在接受抗 CD19 嵌合抗原受体（CAR）T 细胞免疫治疗非霍奇金 B 细胞淋巴瘤后 3 个月发生的 T 细胞淋巴瘤（TCL）。
我们报告一例非霍奇金B细胞淋巴瘤患者接受抗CD19嵌合抗原受体（CAR）T细胞免疫治疗后3个月发生的T细胞淋巴瘤（TCL）。该TCL是在肺癌手术过程中从胸部淋巴结确诊的，表现为CD8+细胞毒性表型并携带JAK3变异，而CAR转基因水平很低。CAR-T 输注前及肺癌组织中均以低水平检出该T细胞克隆。为评估商业化CAR-T（CD19、BCMA）治疗后的继发性原发恶性肿瘤总体风险，我们分析了宾夕法尼亚大学接受治疗的449例患者。中位随访10.3个月时，16例（3.6%）发生继发性原发恶性肿瘤。实体瘤和血液肿瘤的中位发生时间分别为26.4和9.7个月；预计5年累积发生率分别为15.2%和2.3%。总体仅观察到1例TCL，提示CAR-T 治疗后发生TCL的风险较低。
We report a T cell lymphoma (TCL) occurring 3 months after anti-CD19 chimeric antigen receptor (CAR) T cell immunotherapy for non-Hodgkin B cell lymphoma. The TCL was diagnosed from a thoracic lymph node upon surgery for lung cancer. The TCL exhibited CD8 + cytotoxic phenotype and a JAK3 variant, while the CAR transgene was very low. The T cell clone was identified at low levels in the blood before CAR T infusion and in lung cancer. To assess the overall risk of secondary primary malignancy after commercial CAR T (CD19, BCMA), we analyzed 449 patients treated at the University of Pennsylvania. At a median follow-up of 10.3 months, 16 patients (3.6%) had a secondary primary malignancy. The median onset time was 26.4 and 9.7 months for solid and hematological malignancies, respectively. The projected 5-year cumulative incidence is 15.2% for solid and 2.3% for hematological malignancies. Overall, one case of TCL was observed, suggesting a low risk of TCL after CAR T.
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