肿瘤细胞治疗研究
英文原题：Persistent parkinsonism with dopaminergic denervation following axicabtagene ciloleucel therapy for diffuse large B cell lymphoma: a case report.
虽然免疫效应细胞相关神经毒性综合征（ICANS）仍然是CD19靶向CAR-T细胞治疗的主要不良事件之一，但神经退行性样运动障碍典型地与BCMA靶向治疗相关，而非CD19。
虽然免疫效应细胞相关神经毒性综合征（ICANS）仍然是CD19靶向CAR-T细胞治疗的主要不良事件之一，但神经退行性样运动障碍特征性地与BCMA靶向治疗相关，而非CD19。我们报告一例在接受axicabtagene ciloleucel治疗复发弥漫性大B细胞淋巴瘤的患者中，于反复神经功能恶化并伴ICE评分下降期间出现的持续性帕金森综合征的独特病例。值得注意的是，123 I-Ioflupane SPECT显示纹状体多巴胺转运体摄取减少，与黑质纹状体多巴胺能功能障碍一致。该病例扩展了CD19 CAR-T细胞治疗的神经系统谱系，并提示持续性帕金森综合征可能与ICANS存在时间相关性。临床医生应意识到持续性运动障碍可能使CD19 CAR-T细胞治疗病程复杂化，对于神经功能恢复不典型的患者，有必要进行全面的影像学评估。
While immune effector cell-associated neurotoxicity syndrome (ICANS) remains one of the major adverse events in CD19-targeted CAR-T cell therapy, neurodegenerative-like movement disorders are characteristically associated with BCMA-targeted therapies, not CD19. We report a distinct case of persistent parkinsonism that became evident during recurrent neurological deterioration accompanied by a decline in ICE score in a patient treated with axicabtagene ciloleucel for relapsed diffuse large B cell lymphoma. Notably, 123 I-Ioflupane SPECT revealed reduced striatal dopamine transporter uptake, consistent with nigrostriatal dopaminergic dysfunction. This case expands the neurological spectrum of CD19 CAR-T cell therapy and suggests that persistent parkinsonism may occur in temporal association with ICANS. Clinicians should be aware that persistent movement disorders may complicate the course of CD19 CAR-T cell therapy, warranting comprehensive imaging evaluation in patients with atypical neurological recovery.
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