汽车T细胞治疗的传染性并发症:一个纵向风险模型
Michael T Czapka1, Peter A Riedell2, Jennifer C Pisano1
1Department of Medicine, Section of Infectious Disease, University of Chicago, Chicago, Illinois, USA.
概括
用CAR T细胞治疗的患者面临着严重的感染风险. 细菌和菌感染在早期很常见,而呼吸道病毒和肺炎在晚些时候占主导地位,需要仔细监测和风险评估.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 化学抗原受体 (CAR) T细胞疗法是一个不断增长的癌症治疗方法.
- 卡尔T细胞疗法诱导免疫性损害,导致独特的传染性并发症.
- 了解这些感染对于患者管理至关重要.
研究的目的:
- 为了分析接受CD19导向的CAR T细胞治疗的患者的传染性结果.
- 为了确定治疗后感染的风险因素和模式.
- 开发一种用于预测感染风险的模型.
主要方法:
- 成年CAR-T细胞治疗接受者的单中心队列研究.
- 对传染性结果,毒性和免疫标志物的评估长达2年.
- 使用考克斯回归来确定感染预测因子的时间到事件分析.
主要成果:
- 分析了73名患有扩散性大B细胞淋巴瘤的患者.
- 早期感染 (≤30天) 主要是细菌和候选菌 (64%).
- 后来的感染 (30天-2年) 主要是呼吸道病毒和肺炎 (68%).
- 托西利祖马布,ICANS和低中性粒细胞数量预测了早期感染的发生.
结论:
- 呼吸道病毒在CAR T细胞治疗后具有显著的长期感染风险.
- 预测模型可以帮助识别高风险患者.
- 需要进一步的研究来管理这些复杂的感染.
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