非霍奇金淋巴瘤患者 CAR-T 细胞治疗后的吞咽困难结局

INTRODUCTION: Dysphagia is a well-established complication in cancer patients, often resulting from chemoradiation-induced inflammation, fibrosis, and neuromuscular dysfunction.

However, little is known about the incidence and clinical impact of dysphagia in patients undergoing adoptive cellular therapies such as Chimeric Antigen Receptor T-cell (CAR-T) therapy. AREAS COVERED: In this retrospective cohort study, we evaluated 116 patients with non-Hodgkin's lymphoma (NHL) who received CAR-T therapy between January 2017 and May 2023. The overall prevalence of dysphagia was 19. 83%, with a median onset of 6 days and a median duration of 14 days. Dysphagia was significantly associated with cytokine release syndrome (CRS) ( p = 0. 002), immune effector cell-associated neurotoxicity syndrome (ICANS) ( p < 0. 001), advanced tumor stage ( p = 0.

02), ICU admission ( p < 0. 001), and prolonged ICU stay (median 7 days). The Kaplan Meier analysis revealed significantly reduced 6-month overall survival in patients with dysphagia (59. 01%) compared to those without (86. 36%) ( p = 0. 001). EXPERT OPINION: Dysphagia is an underrecognized but clinically significant complication of CAR-T therapy.

Its association with severe treatment-related toxicities and poorer survival suggests the need for routine dysphagia screening and multidisciplinary management in CAR-T treated patients. Early recognition may guide supportive interventions and improve patient outcomes and quality of life.