在商业CAR T细胞治疗后,T细胞淋巴瘤和二次原发性恶性瘤风险较大
Guido Ghilardi1,2,3, Joseph A Fraietta2,4, James N Gerson1,3
1Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Nature medicine
|January 24, 2024
概括
在抗CD19CART治疗后出现了一种罕见的T细胞淋巴瘤 (TCL) 病例. 对449名患者的分析表明,在CAR T细胞免疫治疗后,二次原发性恶性瘤 (包括TCL) 的总体风险较低.
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:
- 化学抗原受体 (CAR) T细胞疗法是B细胞恶性瘤的有前途的治疗方法.
- 潜在的风险,如二次原发性恶性瘤,需要持续调查.
- 了解这些风险对于患者安全和治疗优化至关重要.
研究的目的:
- 报告一种T细胞淋巴瘤 (TCL) 病例,该病例是在抗CD19 CAR T细胞治疗后发生的.
- 评估商业CAR T治疗 (CD19和BCMA) 后二次原发性恶性瘤的总体风险.
主要方法:
- 一个患有TCL后CART治疗的患者的病例报告.
- 在宾夕法尼亚大学,对449名接受商业CAR T治疗的患者进行了回顾性分析.
- 评估二次原发性恶性瘤发生率,发病时间和预计的累积发生率.
主要成果:
- 在抗CD19CART治疗3个月后,发现了一种CD8+细胞毒性T细胞淋巴瘤,具有JAK3变异.
- 在449名患者中,16名 (3.6%) 患有二次原发性恶性瘤 (平均随访时间为10.3个月).
- 预计5年累计发生的固体和血液恶性瘤分别为15.2%和2.3%;观察到一个TCL病例.
结论:
- 虽然在CAR T治疗后发生了罕见的TCL病例,但二次原发性恶性瘤的总体风险似乎很低.
- 需要持续监测和研究,以充分阐明CAR T细胞免疫治疗的长期安全性.
- 这项研究有助于了解CAR T细胞治疗血液癌症的风险效益比.
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