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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Role of Cardio-Oncology Rehabilitation in Hematopoietic Stem Cell Transplantation and Chimeric Antigen Receptor T-Cell (CAR-T) Therapy.
Role of Cardio-Oncology Rehabilitation in Hematopoietic Stem Cell Transplantation and Chimeric Antigen Receptor T-Cell (CAR-T) Therapy.
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异基因造血干细胞移植(allo-HSCT)和CAR-T 细胞治疗在治疗过程中常导致严重的肌肉减少症和恶病质,使患者难以维持运动耐量。因此,已实施“癌症康复”项目以维持和改善体力活动及运动功能。血液系统恶性肿瘤常涉及使用心脏毒性药物。此外,与allo-HSCT相关的移植物抗宿主病以及CAR-T 治疗中的细胞因子释放综合征会升高心血管并发症的风险。因此,建立“心脏肿瘤康复”(CORE)对于支持癌症患者和幸存者至关重要。CORE有望提高生活质量、改善心肺功能、减少癌症和心脏事件复发并延长生存期。我院在HSCT和CAR-T 治疗前进行心肺运动试验,并根据无氧阈心率制定运动处方,同时指导抗阻运动。本报告讨论了接受HSCT和CAR-T 治疗患者CORE的当前趋势以及未来挑战。
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and chimeric antigen receptor T-cell (CAR-T) therapy often lead to severe sarcopenia and cachexia during treatment, making it difficult to maintain exercise tolerance. Consequently, "cancer rehabilitation" programs have been implemented to sustain and improve physical activity and motor function. Hematologic malignancies often involve the use of cardiotoxic drugs.
Moreover, graft-vs. -host disease associated with allo-HSCT and the cytokine release syndrome in CAR-T therapy elevate the risk of cardiovascular complications.
Thus, establishing "cardio-oncology rehabilitation" (CORE) is essential to support cancer patients and survivors. CORE is expected to enhance quality of life, improve cardiopulmonary function, reduce cancer and cardiac events recurrence, and prolong survival.
Our institution conducts cardiopulmonary exercise testing before HSCT and CAR-T therapy, with exercise prescriptions based on heart rate at the anaerobic threshold and guidance on resistance exercises. This report discusses current trends in CORE for patients undergoing HSCT and CAR-T therapy, along with future challenges.
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