在接受CD19+CD22+仿真抗原受体T细胞治疗的儿科患者中,针对复发性/耐药性B型淋巴细胞白血病的感染性并发症
Xiaochen Wu1, Zhanmeng Cao1, Zihan Chen1
1Department of Hematology, Children's Hospital of Soochow University, Suzhou, 215002, Jiangsu, China.
Clinical and experimental medicine
|April 25, 2024
概括
化学抗原受体T细胞 (CAR-T) 疗法可能会在患有复发性/耐药性急性B型淋巴细胞白血病 (R/R B-ALL) 的儿科患者中引起感染. 管理细胞因子释放综合征 (CRS) 可以降低感染风险并改善患者的治疗结果.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 儿科瘤学 儿科瘤学
背景情况:
- 化学抗原受体T细胞 (CAR-T) 疗法在治疗复发性/耐药性急性B型淋巴细胞白血病 (R/R B-ALL) 中显示出有效性.
- 卡特-T疗法与感染的显著风险有关,影响患者的生存和生活质量.
研究的目的:
- 为了追溯分析患有R/R B-ALL的儿科患者接受CAR-T治疗的传染性并发症.
- 为了确定与CAR-T输注后感染发展相关的风险因素.
主要方法:
- 79名患有R/R B-ALL,用CAR-T细胞治疗的儿科患者的回顾性分析.
- 详细审查感染并发症,病原体识别和临床结果.
- 单变量和多变量分析以确定感染风险因素.
主要成果:
- 在输液后的不同阶段,在79名患者中53名患者中观察到88例感染.
- 细菌和病毒病原体是感染的最常见原因.
- 细胞因子释放综合征 (CRS) 级别≥3被确定为感染的重要危险因素 (HR=2.41,P=0.031).
结论:
- 在接受CAR-T治疗的儿科R/R B-ALL患者中,感染是一个主要问题.
- 有效管理和减少细胞因子释放综合征 (CRS) 可能会减轻感染风险.
- 控制CRS的策略可以改善这些患者的长期存活率和生活质量.
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