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呼吸道感染在B细胞成熟后的第100天以后占主导地位,抗原导向的CAR T细胞治疗

Jessica S Little^1,2,3, Megha Tandon^1,4, Joseph Seungpyo Hong^1,4

¹Harvard Medical School, Boston, MA.

|July 24, 2023

概括

在B细胞成熟抗原 (BCMA) 导向的化学抗原受体 (CAR) T细胞治疗后,呼吸道感染很常见,特别是在第100天之后. 低麦球蛋白血症和早期病毒感染增加了晚期呼吸道感染的风险.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
传染性疾病传染性疾病

背景情况:

针对B细胞成熟抗原 (BCMA) 导向的嵌合抗原受体 (CAR) T细胞疗法是复发性/耐药性多发性髓瘤的一种有前途的治疗方法.
感染是CAR-T细胞治疗后的一个重要并发症,在治疗后的早期和晚期存在不同的风险.

研究的目的:

评估BCMA指导的CAR T细胞治疗后的第一年内感染的发生率和特征.
为了确定接受BCMA导向的CAR T细胞治疗的患者晚发性呼吸道感染的危险因素.

主要方法:

分析了一组99名接受BCMA导向CAR T细胞治疗多发性骨髓瘤的成年人.
感染记录在治疗后的365天内;计算累积发病率函数,考虑竞争性风险.
用单变量和多变量考克斯回归模型来确定晚期呼吸道感染的危险因素.

主要成果:

37%的患者在第一年经历了64次感染事件,其中42次是早期事件 (0-100天) 和22次是晚期事件 (101-365天).
呼吸道感染是最常见的,其比例在晚期增加 (31%早期 vs 77%晚期).
低麦球蛋白血症 (HR=6.06) 和早期呼吸道病毒感染 (HR=2.95) 是晚期呼吸道感染的独立风险因素.

结论:

呼吸道感染是BCMA导向的CAR T细胞治疗后的主要感染类型,特别是在晚期.
低麦球蛋白血症和先前的早期呼吸道病毒感染是发展晚期呼吸道感染的关键风险因素.
这些发现可以为针对性预防策略提供信息,以减轻接受BCMA导向CAR T细胞治疗的患者的感染风险.

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