免疫功能障碍和感染 - 结核性淋巴瘤与治疗之间的相互作用:对当前治疗范式和未满足需求的反思
Ernesto Gargiulo1,2, Rebecca Svanberg Teglgaard1, Tereza Faitová1
1Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Acta haematologica
|July 27, 2023
概括
慢性淋巴细胞白血病 (CLL) 治疗可以改善生存率,但不能改善感染结果. 了解治疗对免疫系统的影响对于管理CLL患者感染风险至关重要.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 慢性淋巴细胞白血病 (CLL) 是一种导致免疫功能障碍的血液癌症,导致高感染相关的发病率和死亡率.
- 虽然化学免疫疗法和向疗法等治疗方法可以延长CLL患者的生存期,但它们并没有减少与感染有关的并发症.
- 疗法与瘤微环境的免疫成分相互作用,影响疗效并增加感染风险.
研究的目的:
- 审查在CLL中管理免疫功能障碍和感染的策略.
- 突出了解CLL疗法如何影响疾病-微环境-感染轴的关键需求.
- 强调个性化治疗策略,考虑到治疗对CLL和感染风险的双重影响.
主要方法:
- 审查关于CLL,免疫功能障碍和感染管理的现有文献.
- 讨论化学免疫疗法和向治疗对CLL免疫系统的影响.
- 引入基于机器学习的算法 (CLL治疗-感染模型) 以早期识别高风险患者.
主要成果:
- CLL本身会导致显著的免疫功能障碍,增加感染易感性.
- 癌症疗法虽然对白血病有效,但可以加剧免疫功能障碍和感染风险.
- 一个机器学习模型 (PreVent-ACaLL) 已经开发出来,用于识别患有严重感染高风险的患者.
结论:
- 管理免疫功能障碍和感染对于改善CLL患者的治疗结果至关重要.
- 个性化治疗策略至关重要,平衡治疗效益与感染风险.
- 需要进一步的研究和工具,如CLL治疗-感染模型,以减轻CLL的传染性并发症.
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