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美国移植与细胞治疗学会最佳实践考量:血液恶性肿瘤 CAR-T 细胞治疗后的感染预防与管理

英文原题:Best Practice Considerations by The American Society of Transplant and Cellular Therapy: Infection Prevention and Management After Chimeric Antigen Receptor T Cell Therapy for Hematological Malignancies.

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Best Practice Considerations by The American Society of Transplant and Cellular Therapy: Infection Prevention and Management After Chimeric Antigen Receptor T Cell Therapy for Hematological Malignancies.

PubMed 2024/07/30(内容时间) Transplant Cell Ther Q1 · IF 4.7(JCR 2025)

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中文摘要

嵌合抗原受体(CAR)T细胞治疗快速发展,为血液系统恶性肿瘤患者提供了有希望的治疗选择。然而,相关感染并发症仍是重要问题,因为其增加患者发病率和非复发死亡率。近期流行病学研究揭示了CAR-T 细胞治疗后感染的危险因素,但现有证据主要来自回顾性研究,提示仍需更多前瞻性研究。各医疗机构在管理CAR-T 细胞治疗后感染方面面临挑战,而实践方法不一,凸显了在不同医疗环境中标准化感染预防和管理方案的重要性。因此,美国移植与细胞治疗学会感染性疾病特别兴趣组组建专家组,制定最佳实践考量,旨在指导医疗专业人员优化CAR-T 细胞治疗患者的感染预防与管理,并鉴于其复杂性,倡导在治疗规划阶段及早咨询感染科。通过综合现有证据和专家意见,这些最佳实践建议为理解CAR-T 细胞治疗后的感染风险奠定基础,并提出降低儿童、青少年和成人患者风险的策略。持续研究与协作对于完善并有效落实这些建议至关重要。

展开英文摘要原文

Chimeric antigen receptor (CAR) T-cell therapy is rapidly advancing, offering promising treatments for patients with hematological malignancy.

However, associated infectious complications remain a significant concern because of their contribution to patient morbidity and non-relapse mortality. Recent epidemiological insights shed light on risk factors for infections after CAR T-cell therapy.

However, the available evidence is predominantly retrospective, highlighting a need for further prospective studies. Institutions are challenged with managing infections after CAR T-cell therapy but variations in the approaches taken underscore the importance of standardizing infection prevention and management protocols across different healthcare settings.

Therefore, the Infectious Diseases Special Interest Group of the American Society of Transplantation and Cellular Therapy assembled an expert panel to develop best practice considerations. The aim was to guide healthcare professionals in optimizing infection prevention and management for CAR T-cell therapy recipients and advocates for early consultation of Infectious Diseases during treatment planning phases given the complexities involved.

By synthesizing current evidence and expert opinion these best practice considerations provide the basis for understanding infection risk after CAR T-cell therapies and propose risk-mitigating strategies in children, adolescents, and adults. Continued research and collaboration will be essential to refining and effectively implementing these recommendations.

论文信息

作者
Shahid Z、Jain T、Dioverti V、Pennisi M、Mikkilineni L、Thiruvengadam SK、Shah NN、Dadwal S
单位
Infectious Diseases Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: shahidz@mskcc.org.United States
文献类型
临床实践指南 · 美国 NIH 资助研究 · 非美国政府资助研究
期刊
Transplantation and cellular therapy2024 Oct
原文标识
PubMed 39084261 · DOI 10.1016/j.jtct.2024.07.018