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
英文原题:Disseminated Angioinvasive Fusarium Infection following Chimeric Antigen Receptor T-Cell Therapy in Refractory Diffuse Large B-Cell Lymphoma: A Case Report.
Disseminated Angioinvasive Fusarium Infection following Chimeric Antigen Receptor T-Cell Therapy in Refractory Diffuse Large B-Cell Lymphoma: A Case Report.
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该病例凸显了 CAR-T 治疗后患者对难治性机会性霉菌感染的易感性增高以及潜在的心脏并发症。
引言:接受免疫靶向CAR-T 细胞治疗的患者会出现显著且持久的免疫抑制,容易发生机会性感染。播散性血管侵袭性镰刀菌感染虽不常见,但在该人群中可导致高发病率和死亡率。 病例介绍:我们报告一例难治性弥漫性大B细胞淋巴瘤患者接受CD19靶向CAR-T 治疗后发生播散性血管侵袭性镰刀菌感染。患者出现进行性皮肤损害,组织培养和组织病理证实为Fusarium keratoplasticum复合群感染。最终患者因感染性休克死亡,并伴多因素所致心脏毒性。 结论:本病例提示CAR-T 治疗后患者对难治性机会性霉菌感染及潜在心脏并发症的易感性升高。CAR-T 治疗后出现新发皮损,应尽早活检、进行皮肤培养并及时给予覆盖霉菌的治疗。
INTRODUCTION: Patients receiving immune-directed chimeric antigen receptor T-cell (CAR-T) therapy experience profound, prolonged immunosuppression, predisposing them to opportunistic infections. Disseminated angioinvasive Fusarium infections are uncommon but carry high morbidity and mortality in this population. CASE PRESENTATION: We describe a rare case of disseminated angioinvasive Fusarium infection in a patient with refractory diffuse large B-cell lymphoma following CD19-directed CAR-T-cell therapy. The patient developed progressive cutaneous lesions due to Fusarium keratoplasticum complex, confirmed by tissue culture and histopathology. She ultimately expired due to septic shock complicated by multifactorial cardiotoxicity. CONCLUSION: This case highlights the heightened susceptibility to refractory opportunistic mold infections and potential cardiac complications in patients after CAR-T therapy. New skin lesions in the post-CAR-T period should prompt early biopsy and skin culture with prompt mold coverage.
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