决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
英文原题:Is there a role for palliative care in CAR T-cell therapy?
Is there a role for palliative care in CAR T-cell therapy?
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
综述目的:近期国际指南强调为血液系统恶性肿瘤患者提供姑息治疗的重要性。嵌合抗原受体(CAR)T细胞治疗已改变部分血液系统恶性肿瘤患者的结局,带来持久缓解或治愈的可能。本综述探讨姑息与支持治疗在考虑接受及正在接受CAR-T 细胞治疗患者中日益显现的作用。近期发现:近期研究凸显了CAR-T 细胞治疗过程中不同阶段所伴随的独特且显著的状负担、治疗相关毒性、心理痛苦、经济毒性以及对照护者的影响。
PURPOSE OF REVIEW: Recent international guidelines emphasise the importance of providing palliative care to patients with haematological malignancies. Chimeric antigen receptor (CAR) T-cell therapy has transformed outcomes for patients with selected haematological malignancies, offering the possibility of durable remission or cure.
This review examines the emerging role of palliative and supportive care for patients being considered for and receiving CAR T-cell therapy. RECENT FINDINGS: Recent studies highlight the distinct and significant symptom burden, treatment-related toxicities, psychological distress, financial toxicity, and caregiver impact associated with different stages of the CAR T-cell treatment journey.
These findings suggest multiple opportunities for palliative and supportive care involvement during pre-treatment assessment, throughout the treatment and monitoring period, and into long-term follow-up and survivorship. Evidence from stem cell transplantation provides a strong rationale for early integrated models of palliative care in the CAR T setting.
SUMMARY: Palliative and supportive care can support high-quality, person-centred care for patients receiving CAR T-cell therapy. Future research should focus on defining optimal integrated service models, evaluating how best to provide supportive and palliative care for patients for whom prognosis is uncertain, and establishing the optimal timing and sustainable and equitable approaches to implementation.
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