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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Oral manifestations and dental management in patients undergoing CAR-T cell therapy: a retrospective observational study.
Oral manifestations and dental management in patients undergoing CAR-T cell therapy: a retrospective observational study.
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CAR-T 细胞疗法已成为治疗难治和复发性血液系统恶性肿瘤的高效方法。尽管具有临床获益,CAR-T 疗法也伴有独特毒性谱,包括细胞因子释放综合征(CRS)、免疫效应细胞相关神经毒性综合征(ICANS)及长期免疫抑制。该人群的口腔并发症报告仍不足。本回顾性病例系列旨在描述一家三级转诊中心接受CAR-T 治疗患者的口腔表现和牙科管理。
我们回顾了2024至2025年接受CAR-T 疗法的10例患者医疗及牙科记录,并对人口学资料、血液系统基础诊断、CAR-T 相关毒性和口腔表现进行描述性分析。主要口腔表现包括口干、机会性感染、牙痛和味觉障碍。口腔照护重点为控制症状、预防继发感染,以及在严重免疫抑制期间提供支持性口腔管理。这些发现提示,尽早纳入牙科团队可能有助于支持性照护,尤其是中性粒细胞减少患者机会性感染和牙源性感染灶的发现与管理。标准化口腔评估方案和预防性牙科措施,有望支持该人群临床管理并监测症状。
Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a highly effective treatment for refractory and relapsed hematologic malignancies. Despite its clinical benefits, CAR-T therapy is associated with a unique toxicity profile, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and prolonged immunosuppression. Oral complications in this population remain underreported. This retrospective case series was aimed at describing oral manifestations and dental management in patients undergoing CAR-T therapy at a tertiary referral center.
Medical and dental records of ten patients treated with CAR-T therapy between 2024 and 2025 were reviewed. Demographic data, underlying hematologic diagnoses, CAR-T-related toxicities, and oral findings were analyzed descriptively. The main oral manifestations observed were xerostomia, opportunistic infections, dental pain, and dysgeusia. Oral care focused on symptom control, prevention of secondary infections, and supportive oral management during periods of severe immunosuppression.
These findings suggest that early dental involvement may contribute to supportive care strategies, particularly for the detection and management of opportunistic infections and dental infectious foci in neutropenic patients. Standardized oral assessment protocols and preventive dental measures may contribute to supportive clinical management and symptom monitoring in this patient population.
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