血液细胞移植和仿制抗原受体 (CAR) -T细胞治疗后的COVID-19
Eleftheria Kampouri1,2, Joshua A Hill1,3,4, Veronica Dioverti5
1Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
概括
免疫功能低下的患者,包括接受造血细胞移植 (HCT) 和CAR-T治疗的患者,面临严重的COVID-19风险. 除了疫苗接种之外,新的预防策略至关重要,因为免疫反应不足.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 2019年新冠肺炎疾病 (COVID-19) 继续对免疫功能受损的个体构成重大风险,特别是那些接受了造血细胞移植 (HCT) 或仿真抗原受体-T细胞 (CAR-T) 疗法的人.
- 这些患者群体对疫苗接种有不充分的免疫反应,需要探索针对严重的COVID-19和死亡率的替代和补充预防措施.
研究的目的:
- 审查当前和新兴的治疗和预防策略,在免疫功能低下的患者中治疗COVID-19.
- 突出高风险人群中管理COVID-19的未满足需求,包括最佳的疫苗接种方案和新的治疗方式.
主要方法:
- 对免疫功能低下的主体中COVID-19管理现有文献的审查.
- 对疫苗疗效,抗病毒疗法,康复期血和基于细胞的新疗法数据的分析.
主要成果:
- 疫苗接种在许多免疫功能低下的患者中提供了不足的保护,最佳时间和免疫的相关性仍然不清楚.
- 早期使用或结合使用的抗病毒疗法在减少严重性和预防耐药性方面表现有前途.
- 康复性COVID-19血是轻度至中度病例的潜在选择,而长期的COVID-19和宿主内部变种的出现是严重的担忧.
- 新的SARS-CoV2特异性T细胞和自然杀手 (NK) 细胞疗法显示出对多种变体的潜在活性.
结论:
- 免疫功能低下的患者需要超越标准疫苗接种的定制COVID-19预防和治疗策略.
- 抗病毒组合,康复性血和先进的基于细胞的疗法代表了在这些脆弱个体中管理COVID-19的有希望的途径.
- 需要进一步的研究来建立最佳的方案,并了解新型治疗产品的长期疗效.
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