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
接受 CAR-T 细胞治疗的成人血液病患者中的炎症与急性心脏毒性：一项初步概念验证研究的结果
英文原题：Inflammation and acute cardiotoxicity in adult hematological patients treated with CAR-T cells: results from a pilot proof-of-concept study.
查看英文原题
Inflammation and acute cardiotoxicity in adult hematological patients treated with CAR-T cells: results from a pilot proof-of-concept study.
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研究概要
接受 CAR-T 细胞治疗的患者中早期 CTRCD 发生率较高，且可证实 CTRCD 与炎症之间存在关联。建议采用专门的患者监测方案。
研究思路结论见上方概要
目的
CAR-T（CAR-T）细胞输注是一种快速发展的抗肿瘤疗法；然而，已有报道称可能发生与细胞因子释放综合征（CRS）和全身性炎症相关的心血管（CV）并发症。CARdio-Tox研究旨在阐明与CAR-T 细胞治疗相关的心脏毒性的发生率及其决定因素。
方法
拟接受CAR-T 细胞治疗的血恶性肿瘤患者在基线以及输注后7天和30天接受超声心动图前瞻性评估。研究终点为i）癌症治疗相关心功能障碍（CTRCD）的发生率，CTRCD也针对任何级别的CRS进行了平衡，但CTRCD的发生依据心脏病学指南中肿瘤心脏病学部分（左心室射血分数（LVEF）或整体纵向应变（GLS）下降和/或心脏生物标志物（高敏肌钙蛋白I、利钠肽）升高）以及ii）超声心动图指标与炎症生物标志物的相关性。
结果
CTRCD 在 7 天时的发生率较高（59.3%），尤其是在伴有 CRS 的受试者中。CTRCD 的整合定义能够识别大多数病例（50%）。此外，早期 LVEF 和 GLS 下降与纤维蛋白原和白细胞介素-2 受体水平呈负相关（p 始终为 0.01）。
展开英文摘要原文
METHODS
Patients with blood malignancies candidate to CAR-T cells were prospectively evaluated by echocardiography at baseline and 7 and 30 days after infusion. The study endpoints were i) incidence of cancer therapy-related cardiac dysfunction (CTRCD), CTRCD were also balanced for any grade CRS, but CTRCD occurred of Cardiology Guidelines on Cardio-Oncology (decrements of left ventricular ejection fraction (LVEF) or global longitudinal strain (GLS) and/or elevations of cardiac biomarkers (high sensitivity troponin I, natriuretic peptides) and ii), correlations of echocardiographic metrics with inflammatory biomarkers.
RESULTS
Incidence of CTRCD was high at 7 days (59,3%), particularly in subjects with CRS. The integrated definition of CTRCD allowed the identification of the majority of cases (50%). Moreover, early LVEF and GLS decrements were inversely correlated with fibrinogen and interleukin-2 receptor levels (p always 0.01).
CONCLUSIONS
There is a high incidence of early CTRCD in patients treated with CAR-T cells, and a link between CTRCD and inflammation can be demonstrated. Dedicated patient monitoring protocols are advised.
论文信息
- 作者
- Camilli M、Viscovo M、Felici T、Maggio L、Ballacci F、Carella G、Bonanni A、Lamendola P
- 单位
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. massimiliano.camilli91@gmail.com.Italy
- 期刊
- Cardio-oncology (London, England)2024 Mar 27
- 原文标识
- PubMed 38532515 · DOI 10.1186/s40959-024-00218-0
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