再発/反発性B細胞リンパ腫におけるCAR-T細胞治療後の血小板および線維原動態は,ICANSの発症を予測する可能性がある
Hazim Khatib1, Amit Parizat2, Jabour Halloun1
1Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
European journal of haematology
|February 13, 2026
まとめ
CAR-T療法における免疫エフェクタ細胞関連神経毒性症候群 (ICANS) の予測は極めて重要です. 血小板および線維素素濃度の変化は,リンパ腫患者のICANS発症の早期警告信号として機能する可能性があります.
科学分野:
- 血液学 ヘマトロジ
- 腫瘍学 腫瘍学
- 免疫療法による免疫療法です.
背景:
- CAR-T細胞治療は,再発 / 耐性B細胞リンパ腫の有効性を示しています.
- サイトカイン放出症候群 (CRS) と免疫エフェクター細胞関連神経毒性症候群 (ICANS) は,CAR-T療法の重大な合併症である.
- ICANSの予測と予防は,患者の安全にとって極めて重要です.
研究 の 目的:
- ICANS開発のための凝固パラメータダイナミクスの予測価値を調査する.
- CAR-T療法を受けているB細胞リンパ腫患者の凝固マーカーとICANSの関係を分析する.
主な方法:
- 2つの高等保健センターで265人のB細胞リンパ腫患者の遡及的分析.
- 血小板数,フィブリノゲン,PT,PTT,INR,D-ジメルの毎日のモニタリングは,リンパ節減前から注射後2週間まで行われます.
- 高度イベントを含むICANS患者と無患者の凝固パラメータの比較.
主要な成果:
- ICANSは34%の患者で,高度のICANSは13%で発生しました.
- ICANS患者では,血小板と線維素原体の平均濃度が著しく低下した.
- 高度ICANS発症に先立ち,血小板数の有意な減少とフィブリノゲンのレベルの変化が観察されました.
結論:
- 血小板と線維素原動態は,リンパ腫患者のICANS発症の早期指標として役立つ可能性があります.
- 凝固パラメータのモニタリングは,CAR-T療法後のICANSの予測と管理に役立ちます.
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