肿瘤细胞治疗研究
英文原题：Ruxolitinib for ciltacabtagene autoleucel-associated refractory diarrhea.
难治性腹泻是近来描述的 B 细胞成熟抗原（BCMA）靶向嵌合抗原受体（CAR）T 细胞治疗多发性骨髓瘤后的并发症，报道的死亡率为 36% 至 50%。
难治性腹泻是近期描述的一种多发性骨髓瘤BCMA靶向嵌合抗原受体（CAR）T细胞治疗并发症，既往报道死亡率为36%–50%。最佳临床管理方法尚不明确。本文报告5例接受BCMA CAR-T治疗后出现严重腹泻的患者。我们假设Janus激酶抑制剂ruxolitinib可能有效，因为该药已成功用于异基因骨髓移植后移植物抗宿主病及其他免疫驱动型腹泻综合征。3例患者接受ruxolitinib治疗，均迅速出现临床改善。对其中2例患者治疗前后活检样本进行配对分析，二者均显示组织病理学应答迹象；其中1例患有CAR-T相关胃肠道惰性T细胞淋巴增殖性疾病。
Intractable diarrhea is a recently described complication following B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR) T-cell therapy for multiple myeloma with reported mortality rates of 36% to 50%. The optimal clinical management is unknown. Here, we report a series of 5 patients who presented with severe diarrhea after BCMA CAR T-cell treatment. We hypothesized that the Janus kinase inhibitor, ruxolitinib, might be an effective therapy based on its success in graft-versus-host-disease after allogeneic bone marrow transplant and other immune-driven diarrhea syndromes. Three patients received ruxolitinib, all of whom experienced rapid clinical improvement. Among the 2 patients with matched pretreatment and posttreatment biopsies, both showed signs of histopathologic response, including 1 with CAR T-cell-associated indolent T-cell lymphoproliferative disease of the gastrointestinal tract.
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