在 axicabtagene ciloleucel 之前的 Bendamustine 淋巴损耗是安全的,并且与减少的炎症性细胞因子相关
Guido Ghilardi1,2,3, Luca Paruzzo1,2,3,4, Jakub Svoboda1,2,3
1Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA.
Blood advances
|December 19, 2023
概括
班达穆斯丁 (Benda) 是弗鲁达拉宾/环胺 (Flu/Cy) 的安全替代品,用于化学抗原受体T细胞 (CART) 治疗中的淋巴缺血,具有类似的疗效,但降低了诸如细胞因子释放综合征和神经毒性等毒性.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 淋巴细胞减少 (LD) 对仿制抗原受体T细胞 (CART) 免疫疗法至关重要.
- 标准的LD疗法包括弗鲁达拉宾/环胺 (Flu/Cy).
- 班达穆斯丁 (Benda) 是一种替代性LD剂.
研究的目的:
- 为了比较Benda与Flu/Cy在CD19导向,CD28辅助刺激CART (axicabtagene ciloleucel,axi-cel) 之前的LD的安全性和有效性.
- 评估LD疗法对细胞因子水平和代谢变化的影响.
主要方法:
- 对59名患有大B细胞淋巴瘤 (LBCL) 和卵泡淋巴瘤 (FL) 的患者进行了回顾性分析,这些患者接受了轴细胞治疗.
- 在Flu/Cy和Benda组之间比较完全缓解率,无进展生存率和整体生存率.
- 在LD前后分析血清细胞因子水平和代谢概况.
主要成果:
- 班达和Glu/Cy的疗效相似,完全缓解率分别为50.0%和51.4%.
- 随着Benda的使用,任何级别的细胞因子释放综合征 (72.7% vs 91.9%) 和神经毒性 (18.2% vs 45.9%) 的发生率显著降低.
- 与流感/Cy.相比,使用Benda减少了≥3级中性质衰竭,感染和中性质衰竭发烧的发生率.
- 流感/Cy与炎症性细胞因子增加和对氧化还原平衡至关重要的代谢物减少有关.
结论:
- 班达穆斯丁LD是一种安全有效的Flu/Cy替代品,用于CD19导向的CART免疫治疗.
- 班达的疗效与Flu/Cy相当,安全性明显提高.
- 与Glu/Cy相比,Bendamustine LD与有利的细胞因子和代谢概况有关.
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