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 细胞治疗后发生的癌症相关性视网膜病变
英文原题：CANCER-ASSOCIATED RETINOPATHY AFTER CHIMERIC ANTIGEN RECEPTOR T-CELL THERAPY.
查看英文原题
CANCER-ASSOCIATED RETINOPATHY AFTER CHIMERIC ANTIGEN RECEPTOR T-CELL THERAPY.
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研究概要
该患者在接受 CAR-T 细胞治疗后立即发生 CAR，而 CAR-T 细胞治疗会耗竭 B 细胞。这提示 CAR 的病理生理机制可能并非如通常认为的那样纯粹由自身抗体介导。
研究思路结论见上方概要
目的
描述一例CAR-T（CAR-T）细胞治疗后发生的癌症相关性视网膜病变（CAR）。
方法
回顾性病例报告。
结果
一名71岁男性，患有对多种化疗耐药的滤泡性淋巴瘤，接受了CAR-T 细胞治疗。CAR-T 启动两周后，他出现双眼周边视力迅速下降。荧光血管造影显示周边血管充盈减弱，光学相干断层扫描显示椭圆体带丢失，中心凹保留。视网膜电图显示视杆反应无法检测，视锥反应严重延长和减弱。抗视网膜抗体检测显示，Western blot中抗烯醇化酶和抗热休克蛋白60抗体阳性，免疫组化显示外节强染色。该患者被诊断为CAR，目前每月接受IV immunoglobulin（IVIg）治疗，中心视力稳定。
展开英文摘要原文
PURPOSE
To describe a case of cancer-associated retinopathy (CAR) after chimeric antigen receptor T (CART)-cell therapy.
METHODS
Retrospective case report.
RESULTS
A 71-year-old man with follicular lymphoma refractory to multiple chemotherapies underwent CART-cell therapy. Two weeks after CART initiation, he presented with rapid-onset decreased peripheral vision in both eyes. Fluorescein angiography showed attenuation of peripheral vessel filling, and optical coherence tomography showed loss of ellipsoid zone with foveal sparing. Electroretinography revealed nondetectable rod responses and severely prolonged and diminished cone responses. Antiretinal antibody testing showed positive antienolase and antiheat shock protein 60 antibodies on Western blot with strong staining of the outer segments on immunohistochemistry. The patient was diagnosed with CAR and is currently on monthly IV immunoglobulin (IVIg) with stable central visual acuity.
CONCLUSION
This patient developed CAR immediately after receiving CART-cell therapy, which depletes B cells. This suggests that CAR pathophysiology may not be purely autoantibody mediated as typically believed.
论文信息
- 作者
- Mann M、Meng D、Liu R、Zhou HW、Bian Y、Raevis JJ、Sobrin L、Leukam M
- 单位
- Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.Israel
- 文献类型
- 病例报告
- 期刊
- Retinal cases & brief reports2026 May 1
- 原文标识
- PubMed 42060919 · DOI 10.1097/ICB.0000000000001737