延迟细胞输液对大B细胞淋巴瘤患者的影响,这些患者接受了仿真抗原受体T细胞治疗
Andrew P Jallouk1, Naishu Kui2, Ryan Sun2
1Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX; Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN.
Haematologica
|November 30, 2023
概括
淋巴损伤化学疗法 (LDC) 后T细胞输注的仿真抗原受体 (CAR) 延迟与大B细胞淋巴瘤患者的结果更差有关. 感染通常导致这些延迟,影响反应率和生存率.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 血液学 血液学 血液学
背景情况:
- 淋巴切除化学疗法 (LDC) 后的并发症可能会延迟仿真抗原受体 (CAR) T 细胞输液.
- 这些输液延迟对大B细胞淋巴瘤 (LBCL) 临床结果的影响尚未明确.
研究的目的:
- 为了研究 axicabtagene ciloleucel (axi-cel) 输液在LDC后的延迟和复发/耐药LBCL患者的临床结果之间的关联.
主要方法:
- 对240名用轴细胞治疗的LBCL患者的回顾性分析.
- 及时输注与延迟输注患者之间的临床特征和结果的比较.
- 采用了多变量分析和倾向性得分匹配.
主要成果:
- 16.7%的患者经历了延迟的轴细胞输液,主要是由于感染 (85%).
- 延迟输液与较低的基线中性粒细胞计数,血小板,血红蛋白和较高的C反应蛋白有关.
- 延迟输液的患者在30日的整体反应率较低,无进展生存期 (PFS) 较短,整体生存期 (OS) 较短.
- 延迟输液和PFS之间的负相关性在多变量分析和倾向性得分匹配后仍然存在.
- 较长的延迟 (>5天) 与较短的延迟 (2-5天) 或及时输注相比,与明显更糟糕的PFS有关.
结论:
- 在LDC后CAR-T细胞的延迟与LBCL患者的不良临床结果有关.
- 感染是这些延迟的主要原因,强调需要策略来管理并发症和优化治疗时间表.
- 需要进一步的研究来开发旨在改善输液延迟患者疗效的干预措施.
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