在化学抗原受体T细胞疗法后,细胞巨乳病毒 (CMV) 重活性和CMV特异性细胞介导免疫
Eleftheria Kampouri1, Sarah S Ibrahimi1, Hu Xie2
1Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
概括
在化学抗原受体T细胞治疗 (CARTx) 后,细胞巨乳病毒 (CMV) 再激活发生在25%的患者中. 针对BCMA的CARTx和皮质类固醇使用增加了CMV重新激活的风险,这表明有针对性的监测.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 由于监测有限,细胞巨乳病毒 (CMV) 流行病学后基因组抗原受体T细胞疗法 (CARTx) 的研究不足.
- 了解CARTx后的CMV发病率和风险因素对于患者管理至关重要.
研究的目的:
- 为了前性地评估CARTx.之后的CMV再激活的发生率.
- 为了确定与CMV重新激活相关的风险因素.
- 评估CMV特异性细胞介导免疫 (CMV-CMI) 在预测活性化中的作用.
主要方法:
- 在接受CARTx的72名CMV阳性成年人中,每周监测CMV活性,直到治疗后12周.
- 用干扰素-释放试验评估CMV特异性细胞介导免疫力 (CMV-CMI).
- 考克斯回归和ROC曲线用于分析风险因素和预测绩效.
主要成果:
- 在CARTx后的25%患者中发生了CMV重新激活,没有观察到末端器官疾病.
- 针对BCMA的CARTx和皮质类固醇使用 (>3天) 与增加的CMV再激活风险显著相关.
- 在输液后的第2周和之前的抗瘤疗法中,降低CMV-CMI显示了与重新激活的可能关联.
结论:
- 在CARTx后,CMV的重新激活是一个重大问题,特别是在BCMA向治疗和皮质类固醇使用时.
- 对于高风险患者,建议在CARTx后2至6周进行向的CMV监测.
- 对CMV-CMI的预测作用的进一步研究可能会改进监测策略.
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