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
在单一机构中为血液病注射 Evusheld®的综合流程
英文原题：Comprehensive procedure for injecting Evusheld® for hematological diseases in a single institute.
查看英文原题
Comprehensive procedure for injecting Evusheld® for hematological diseases in a single institute.
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中文摘要
Tixagevimab 和 cilgavimab（EVA，Evusheld®）是一种单克隆抗体联合治疗，由两种针对严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的中和抗体组成。EVA 对 2019 冠状病毒病显示出预防和治疗效果。日本血液学会推荐 EVA 用于正在接受积极治疗的患者，但各机构自行决定是否全面给药。
我们制定了一套系统性流程，用于对血液系统恶性肿瘤患者进行全面的 EVA 预防性注射，避免任何适应症过度或不足。我们列出了 2022 年 11 月至 2023 年 3 月期间所有符合所需适应症的患者。
我们纳入了 178 例病例，其中女性 84 例，男性 94 例，中位年龄为 70 岁（范围：19-90）。基础疾病为髓系肿瘤 36 例（20%），淋系肿瘤 75 例（73%），以及其他。适应症分别为强化血液系统恶性肿瘤治疗、12 个月内接受利妥昔单抗治疗、布鲁顿酪氨酸激酶抑制剂治疗、CAR-T 细胞免疫治疗后，以及干细胞移植后，分别为 74 例（41%）、73 例（41%）、3 例（2%）、5 例（3%）和 23 例（13%）。在 178 例中，22 例（12.4%）拒绝 EVA 注射。
此外，42 例和 136 例分别在门诊和住院接受给药。超过 95% 的列入病例在 3 个月内接受了 EVA 注射。在他们中（N = 156）未观察到严重毒性，8 例（5.2%）出现突破性 SARS-CoV-2 感染，显著低于未接受 EVA 者（22 例中的 4 例[18.2%]）（P = 0.02）。两组均无中度或重度感染病例。这项单中心经验表明，全面的 EVA 注射管理有效地实现了更安全的完成率，并具有较好的临床影响。
展开英文摘要原文
Tixagevimab and cilgavimab (EVA, Evusheld®), monoclonal antibody combination treatments, consisted of two neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). EVA showed prophylactic and therapeutic effects against coronavirus disease 2019. The Japanese Society of Hematology recommended EVA for such patients with active treatment, but each institution decided on comprehensive administration.
We develop a systematic procedure for comprehensive EVA injection prophylactically in patients with hematological malignancies without any over/under-indication.
We listed all patients with the required indications from November 2022 to March 2023.
We included 178 cases, 84 females and 94 males, with a median age of 70 (range: 19-90) years. Underlying diseases are myeloid neoplasms in 36 (20%), lymphoid neoplasms in 75 (73%), and others. Indications were intensively hematological malignancy treatment, rituximab treatment within 12 months, burton kinase inhibitor treatment, after chimeric antigen receptor T cell immunotherapy, and after stem cell transplantation in 74 (41%), 73 (41%), 3 (2%), 5 (3%), and 23 (13%) cases, respectively. Of the 178 cases, 22 (12. 4%) refused EVA injection.
Further, 42 and 136 cases were administered outpatient and inpatient, respectively. Over 95% of the listed cases received EVA injection within 3 months. No severe toxicities were observed among them (N = 156), and 8 (5. 2%) cases had breakthrough SARS-CoV-2 infection, which was significantly lower (P = 0.
02) than those without EVA (4 [18. 2%] of 22 cases). Both groups showed no moderate or severe infection cases. This single-center experience showed that comprehensive EVA injection management effectively generated safer completion with preferable clinical impact.
论文信息
- 作者
- Imataki O、Yoshida S、Ishida T、Uemura M、Fujita H、Kadowaki N
- 单位
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-Town, Kita-County, Kagawa, 761-0793, Japan. imataki.osamu@kagawa-u.ac.jp.Japan
- 期刊
- Annals of hematology2024 Aug
- 原文标识
- PubMed 38734996 · DOI 10.1007/s00277-024-05792-y