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
肥胖对接受 CAR-T 细胞治疗的弥漫大 B 细胞淋巴瘤患者的影响
英文原题：Impact of Obesity on Patients with Diffuse Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy.
查看英文原题
Impact of Obesity on Patients with Diffuse Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy.
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研究概要
急性肾损伤、心脏并发症、白细胞减少、神经毒性、肺栓塞和感染的发生率在这两组之间相当。我们的发现强调需要制定个体化管理策略，以改善肥胖患者接受 CAR-T 治疗后的结局。
研究思路结论见上方概要
背景
肥胖与传统癌症治疗的不良结局相关。然而，其对弥漫性大B细胞淋巴瘤（DLBCL）患者接受嵌合抗原受体（CAR）T细胞治疗的影响仍不明确。本研究旨在评估肥胖如何影响接受CAR-T 治疗的DLBCL患者的院内结局。
方法
利用全国再入院数据库（NRD），我们纳入了2018年至2020年间接受CAR-T 治疗的年龄≥18岁的DLBCL成人患者。我们进行了倾向性评分匹配（卡钳值0.2，1:1比例），并调整了以下混杂变量：年龄、合并症以及社会因素，包括吸烟、饮酒和非法药物使用。数据分析使用R studio软件进行。
结果
研究共纳入1,874例接受CAR-T 治疗的DLBCL患者（9.1%伴肥胖，90.9%不伴肥胖）。经倾向性评分匹配后，共有160例伴肥胖患者（50.0%，年龄59.7 12.2岁，女性41.9%）和160例不伴肥胖患者（50.0%，年龄58.6 13.0岁，女性41.3%）。与不伴肥胖的患者相比，伴肥胖患者的早期死亡率（10.6% vs. 4.4%，p = 0.03）和非居家出院率（18.8% vs. 8.1%，p = 0.01）显著更高。30天再入院率（18.1% vs. 21.3%，p = 0.48）无显著差异。
展开英文摘要原文
METHODS
Using the National Readmission Database (NRD), we included adults' age 18 with DLBCL who received CAR-T therapy between 2018 and 2020. We performed propensity score matching (caliper of 0.2, 1:1 ratio) and adjusted the following confounding variables: age, comorbidities, and social factors including smoking, alcohol use, and illicit drug use. Data analysis was conducted using R studio software.
RESULTS
A total of 1,874 patients with DLBCL who received CAR-T therapy (9.1% with obesity and 90.9% without) were included in the study. After propensity score matching, there were 160 patients with obesity (50.0%, 59.7 12.2 years of age, 41.9% female) and 160 patients without obesity (50.0%, 58.6 13.0 years of age, 41.3% female). Patients with obesity had significantly higher rates of early mortality (10.6% vs. 4.4%, p = 0.03) and non-home discharge (18.8% vs. 8.1%, p = 0.01) compared to those without obesity. There were no significant differences in 30-day readmission (18.1% vs. 21.3%, p = 0.48).
CONCLUSION
The rates of acute kidney injury, cardiac complications, leukopenia, neurotoxicity, pulmonary embolism, and infection were comparable between these two groups. Our findings underscore the need for tailored management strategies to improve outcomes following CAR-T therapy for patients with obesity.
论文信息
- 作者
- Tan JY、Yeo YH、Wong HKK、Elemian S、Mir M、Ang QX、Roy AM、Ezekwudo D
- 第一作者单位
- Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, New Jersey, USA.United States
- 通讯作者单位
- Department of Hematology/Oncology, New York Medical College at Saint Michael's Medical Center, Newark, New Jersey, USA, hamidshaaban@gmail.com.United States
- 期刊
- Oncology2026
- 原文标识
- PubMed 40517758 · DOI 10.1159/000545933