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CSF IL-6 监测在与 Epcoritamab 治疗相关 ICANS 管理中的应用价值:一例病例报告及文献综述

英文原题:Utility of CSF IL-6 monitoring in managing ICANS associated with Epcoritamab treatment: a case report and literature review.

查看英文原题

Utility of CSF IL-6 monitoring in managing ICANS associated with Epcoritamab treatment: a case report and literature review.

PubMed 2025/01/01(内容时间) J Clin Exp Hematop Q4 · IF 1.4(JCR 2025)

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中文摘要

免疫效应细胞相关神经毒性综合征(ICANS)是接受双特异性抗体和 CAR-T 细胞疗法等先进免疫治疗患者的严重并发症。尽管免疫效应细胞相关脑病(ICE)评分常用于评估 ICANS 严重程度,但合并用药、基础合并症和其他外部因素可能影响其诊断准确性。本病例报告介绍一名弥漫大 B 细胞淋巴瘤患者,其在接受 epcoritamab 治疗期间发生 ICANS。

值得注意的是,脑脊液(CSF)白细胞介素 6(IL-6)水平升高与患者神经毒性的临床病程相关。传统评分系统可能受无关因素影响,而 CSF IL-6 水平似乎更直接反映 ICANS 的严重程度及进展。这些发现与 CAR-T 治疗患者的类似报告一致,提示 CSF IL-6 可能成为可靠的 ICANS 进展标志物。在不同临床情境中系统测量 CSF IL-6 的进一步研究,有助于验证其作为生物标志物的作用,提高诊断精准度并指导最佳 ICANS 管理策略。

展开英文摘要原文

Immune effector cell-associated neurotoxicity syndrome (ICANS) is a serious complication observed in patients receiving advanced immunotherapies such as bispecific antibodies and CAR-T cell therapies.

Although the Immune Effector Cell-Associated Encephalopathy (ICE) score is commonly used to assess ICANS severity, its diagnostic accuracy can be compromised by factors such as concomitant medications, underlying comorbidities, and other external influences. This case report discusses a patient with diffuse large B-cell lymphoma who developed ICANS while receiving Epcoritamab.

Notably, elevated interleukin-6 (IL-6) levels in the cerebrospinal fluid (CSF) correlated with the patient's clinical course of neurotoxicity. In contrast to conventional scoring systems, which can be affected by unrelated factors, CSF IL-6 levels appeared to more directly reflect the severity and progression of ICANS.

These findings are consistent with similar reports from patients treated with CAR-T cells, suggesting that CSF IL-6 may serve as a reliable marker for ICANS progression.

Further research that systematically measures CSF IL-6 in diverse clinical contexts could help validate its role as a biomarker, enhancing diagnostic precision and guiding optimal management strategies for ICANS.

论文信息

作者
Takahata A、Akita K、Shimada T、Bando K、Toyota S
单位
Department of Hematology, Yokosuka Kyosai Hospital, Kanagawa, Japan.Japan
文献类型
病例报告 · 综述
期刊
Journal of clinical and experimental hematopathology : JCEH2025
原文标识
PubMed 40159285 · DOI 10.3960/jslrt.24080