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
CAR-T 细胞治疗的风湿性并发症：单中心经验
英文原题：Rheumatologic complications of CAR-T Cell therapy. Experience of a single center.
查看英文原题
Rheumatologic complications of CAR-T Cell therapy. Experience of a single center.
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研究概要
临床医生应了解这些潜在并发症，以确保及时诊断和处理。
中文摘要
方法
回顾性研究分析2020年1月至2024年5月单中心接受CAR-T 治疗的310名患者中的风湿性并发症。
结果
研究发现6名患者（1.9%）发生风湿性并发症，包括活检证实结节的类风湿关节炎（RA）样表现、回文性风湿症、肌炎、坏死性筋膜炎和骨坏死（ON）。症状于治疗后2至11周出现，炎性关节炎出现较晚。值得注意的是，2名患者发生伴皮下结节病的RA样关节炎；其他患者表现为短暂性关节炎发作，以及严重软组织和关节受累，例如假性痛风样发作和ON。影像学检查和活检证实了诊断。治疗包括糖皮质激素、羟氯喹和非甾体抗炎药，治疗应答不一。
结论
临床医师应了解这些潜在并发症，以确保及时诊断和处理。仍需进一步研究阐明这些自身免疫现象的机制并制定标准化治疗方案。
展开英文摘要原文
METHODS
We conducted a retrospective study to analyze rheumatic complications in 310 patients treated with CAR-T therapy at a single center from January 2020 to May 2024.
RESULTS
We identified six patients (1.9 %) who developed rheumatic complications, including rheumatoid arthritis (RA)-like manifestations with biopsy-proven nodules, palindromic rheumatism, myositis, necrotizing fasciitis, and osteonecrosis (ON). Symptoms appeared between 2 to 11 weeks after therapy, with inflammatory arthritis manifesting later. Notably, 2 patients developed RA-like arthritis with subcutaneous nodulosis, while others presented with transient arthritis flares, severe soft tissue and joint involvement, such as pseudo-podagra and ON. Imaging findings and biopsies confirmed the diagnoses. Treatment included glucocorticoids, hydroxychloroquine, and nonsteroidal anti-inflammatory drugs, with variable responses.
CONCLUSIONS
Clinicians should be aware of these potential complications to ensure prompt diagnosis and management. Further research is needed to elucidate the mechanisms underlying these autoimmune phenomena and to establish standardized treatment protocols.
论文信息
- 作者
- Gómez-Puerta JA、Monegal A、Ponce A、Peris P、Martínez-Cibrian N、Sarmiento-Monroy JC、Ortiz-Maldonado V、Triguero A
- 单位
- Department of Rheumatology, Hospital Clínic; University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Electronic address: jagomez@clinic.cat.Spain
- 文献类型
- 非美国政府资助研究
- 期刊
- Seminars in arthritis and rheumatism2025 Apr
- 原文标识
- PubMed 39754918 · DOI 10.1016/j.semarthrit.2024.152610