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CAR-T 细胞治疗并发症的新型治疗方式:病例报告

英文原题:Novel Treatment Modality for Chimeric Antigen Receptor T-cell Therapy Complications: A Case Report.

查看英文原题

Novel Treatment Modality for Chimeric Antigen Receptor T-cell Therapy Complications: A Case Report.

PubMed 2024/07/27(内容时间) Cureus

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中文摘要

免疫细胞相关神经毒性综合征(ICANS)和细胞因子释放综合征(CRS)均是嵌合抗原受体(CAR)T细胞治疗的常见不良反应。Blinatumomab是B细胞急性淋巴细胞白血病(B-ALL)患者常用的CAR-T 细胞治疗药物。我们的患者既往病史复杂,包括难治性B-ALL,在接受blinatumomab CAR-T 细胞治疗后出现了CRS和ICANS。早期临床识别ICANS、使用免疫效应细胞脑病评分进行监测、遵循ICANS分级的适当方案以及加用anakinra(IL-1受体拮抗剂)是管理其病情的关键步骤。该患者的管理和监测方法独特之处在于我们在标准治疗方案中加用了anakinra。通过本报告,我们强调需要进一步研究CAR-T 细胞治疗方案以及如何降低其不良反应的发病率和死亡率。

展开英文摘要原文

Immune cell-associated neurotoxicity syndrome (ICANS) and cytokine release syndrome (CRS) are both common adverse effects of chimeric antigen receptor (CAR) T-cell therapy. Blinatumomab is a commonly used CAR T-cell treatment in patients with B-cell acute lymphoblastic leukemia (B-ALL).

Our patient presented with an extensive past medical history, including refractory B-ALL, and developed CRS and ICANS following treatment with blinatumomab CAR-T cell therapy. Early clinical detection of ICANS, monitoring using immune effector cell encephalopathy scores, following the appropriate protocol for ICANS grade, and adding anakinra (IL-1 receptor antagonist) were crucial steps in managing his condition.

The approach to managing and monitoring this patient was unique in that we added anakinra to the standard treatment regimen. With this report, we emphasize the need for further research regarding CAR T-cell therapeutic regimens and how to decrease the morbidity and mortality of its adverse effects.

论文信息

作者
Rente Lavastida D、De Filippis S、Rivera Torres EG、Aldanese A、Ruxmohan S
第一作者单位
Clinical Sciences, St. George's University School of Medicine, St. George's, GRD.
通讯作者单位
Neurocritical Care, University of Texas (UT) Southwestern Medical Center, Dallas, USA.United States
文献类型
病例报告
期刊
Cureus2024 Jul
原文标识
PubMed 39188428 · DOI 10.7759/cureus.65497