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
英文原题:Real-world infectious complications of CD3/CD20 bispecific antibodies in relapsed/refractory non-Hodgkin lymphoma.
Real-world infectious complications of CD3/CD20 bispecific antibodies in relapsed/refractory non-Hodgkin lymphoma.
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感染发生在高达44%接受CD3/CD20双特异性抗体(BsAb)治疗的试验参与者中,但真实世界数据有限。在这项纳入48例接受商业化BsAb治疗的真实世界R/R-NHL患者的研究中,分别有50%和23%的患者发生任何级别感染和3级感染。12个月时每例患者累计感染数为1.3(95% CI:0.81-2.1)。严重感染大多为细菌性。仅发生1例5级事件,未观察到COVID-19相关死亡。严重中性粒细胞减少、淋巴细胞减少和低丙种球蛋白血症分别发生于39.6%、83.3%和64.1%的患者。在探索性单变量分析中,近期感染、侵袭性组织学、既往治疗线数、CAR-T 暴露以及严重治疗中出现淋巴细胞减少和低丙种球蛋白血症与感染风险增加相关。此外,在Cox比例风险模型中,感染与总生存期降低相关(HR 3.4,p = 0.0066)。这些真实世界发现强化了在BsAb治疗后监测感染性并发症的必要性。
Infections occur in up to 44% of trial participants treated with CD3/CD20 bispecific antibodies (BsAb), but real-world data are limited. In this study of 48 real-world R/R-NHL patients receiving commercial BsAbs, 50% and 23% experienced any-grade and grade 3 infections, respectively. The cumulative number of infections per patient at 12 months was 1. 3 (95% CI: 0. 81-2. 1). Severe infections were mostly bacterial.
Only 1 grade 5 event occurred, and no COVID-19-related deaths were observed. Severe neutropenia, lymphopenia, and hypogammaglobulinemia occurred in 39. 6, 83. 3, and 64. 1% of patients, respectively. In exploratory univariate analyses, recent infection, aggressive histology, number of prior lines of therapy, CAR T exposure, and severe treatment-emergent lymphopenia and hypogammaglobulinemia were linked to increased infection risk.
Moreover, infection was associated with decreased overall survival (HR 3. 4, p = 0. 0066) in the Cox proportional hazards model. These real-world findings reinforce the need for monitoring of infectious complications following BsAb therapy.
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