肿瘤细胞治疗研究
英文原题：Therapy related acute myeloid leukemia secondary to CAR-T therapy in refractory/relapsed multiple myeloma patient showing poor prognosis.
对于接受 CAR-T 免疫治疗的患者，长期密切监测至关重要，尤其要注意血液系统恶性肿瘤的潜在发生。
人们日益关注 CAR-T 免疫治疗后期出现的不良事件，包括血液系统恶性肿瘤。本文报告本中心一例 CAR-T 免疫治疗后继发骨髓增生异常综合征（MDS）/急性髓系白血病（AML）的病例。该复发/难治性 MM 患者接受包括化疗、靶向药物和自体干细胞移植在内的系统治疗，尤其在 BCMA CAR-T 免疫治疗后进展为 MDS 和 AML；即使接受异基因造血干细胞移植，极差预后仍无法挽回。进一步荟萃分析也显示纳入研究整体存在相当异质性，包括 CD19 和 BCMA CAR-T 亚组。总之，必须对接受 CAR-T 免疫治疗的患者开展长期密切监测，特别关注血液系统恶性肿瘤的潜在发生。
There has been a growing concern regarding the adverse events including hematological malignancies which occurring in the later stages following CAR-T immunotherapy. Here, we presented a case of secondary MDS/AML following CAR-T immunotherapy in our center. This refractory/relapsed MM patient who received systematic treatment including chemotherapy and targeted drug as well as autologous stem cell transplantation was developed into MDS and AML especially after BCMA CAR-T immunotherapy, and even allogeneic hematopoietic stem cell transplantation could not save the very poor prognosis. Further meta-analysis also demonstrated the considerable heterogeneity through the total studies CD19 and BCMA CAR-T subgroups. In conclusion, it is imperative that long-term and close monitoring for patients undergoing CAR-T immunotherapy, with particular attention to the potential development of hematological malignancies.
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