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
CAR-T 细胞采集至输注时间延长与弥漫大 B 细胞淋巴瘤较差结局相关
英文原题：Prolonged chimeric antigen receptor-T apheresis to infusion time is associated with inferior outcomes in diffuse large B-cell lymphoma.
查看英文原题
Prolonged chimeric antigen receptor-T apheresis to infusion time is associated with inferior outcomes in diffuse large B-cell lymphoma.
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中文摘要
CAR-T 细胞疗法对复发/难治性（r/r）弥漫大 B 细胞淋巴瘤（DLBCL）有效。然而，受机构接诊能力有限和桥接治疗时间较长影响，单采至输注之间经常延迟，其临床影响尚不明确。
本研究回顾性分析了在京都大学医院接受 CAR-T 治疗的 r/r DLBCL 患者。90 例患者中，单采至输注的中位间隔为 66 天（范围 28–203 天）。患者分为延迟组（≥66 天）和未延迟组（<66 天）。输注时的基线特征相似，但延迟组的结外受累和疾病稳定/进展（SD/PD）等不良特征较少。多变量分析显示，输注延迟是无进展生存期的不良预后因素（校正风险比［aHR］3.13；95% 置信区间［CI］1.63–6.00；p = 0.001）；其他因素包括结外受累（aHR 2.39；p = 0.004）、SD/PD（aHR 2.66；p = 0.005）、肿瘤负荷大（aHR 3.08；p = 0.008）以及使用 tisa-cel（aHR 5.26；p = 0.001）。延迟组总生存期也较差（aHR 2.53，95% CI 1.29–4.96；p = 0.007）。通过改善流程和机构能力缩短单采至输注间隔，并避免对无应答者进行过长的桥接治疗，可能有助于改善结局。
展开英文摘要原文
Chimeric antigen receptor (CAR) T-cell therapy is effective for relapsed/refractory (r/r) diffuse large B-cell lymphoma (DLBCL).
However, delays between apheresis and infusion frequently occur due to limited facility capacity and prolonged bridging therapy, and the clinical impact of such delays remains uncertain.
We retrospectively analysed R/R DLBCL patients who underwent CAR-T-cell therapy at Kyoto University Hospital. Among 90 patients, the median apheresis to infusion interval was 66 days (range, 28-203). Patients were categorized into delayed ( 66 days) and non-delayed (<66 days) groups. Baseline characteristics at infusion were similar, whereas adverse features such as extranodal involvement and stable/progressive disease (SD/PD) were less common in the delayed group.
Multivariate analysis identified delayed infusion as a significant negative prognostic factor for progression-free survival (adjusted hazard ratio [aHR] 3. 13; 95% confidence interval [CI] 1. 63-6. 00; p = 0. 001), along with extranodal involvement (aHR 2. 39; p = 0. 004), SD/PD (aHR 2. 66; p = 0. 005), bulky disease (aHR 3. 08; p = 0. 008) and treatment with tisa-cel (aHR 5. 26; p = 0. 001).
Overall survival was also inferior in the delayed group (aHR 2. 53, 95% CI 1. 29-4. 96; p = 0. 007). Minimizing apheresis to infusion interval through improved workflows, institutional capacity and avoiding prolonged bridging in non-responders may enhance outcomes.
论文信息
- 作者
- Morimoto S、Jo T、Kitawaki T、Sakamoto T、Mizumoto C、Kanda J、Nishikori M、Yamashita K
- 单位
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan.Japan
- 期刊
- British journal of haematology2025 Oct
- 原文标识
- PubMed 40785504 · DOI 10.1111/bjh.70090
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