关于CAR T毒性的机制和管理
Christopher J Ferreri1, Manisha Bhutani1
1Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health Wake Forest University School of Medicine, Charlotte, NC, United States.
Frontiers in oncology
|June 5, 2024
概括
化学抗原受体 (CAR) T细胞疗法为某些血液癌症提供了改善的结果. 然而,控制细胞因子释放综合征和神经毒性等毒性对患者安全和治疗成功至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 细胞疗法细胞疗法
背景情况:
- 化学抗原受体 (CAR) T细胞疗法已经彻底改变了B细胞恶性瘤的治疗方法.
- 尽管 CAR T 细胞疗法具有很高的疗效,但与显著的不良事件有关.
- 这些毒性会导致严重的发病率和非复发性死亡率.
研究的目的:
- 审查目前对CAR T细胞治疗相关毒性的理解.
- 讨论这些不良事件背后的病理生理机制.
- 为分类和管理CAR T细胞治疗毒性提供指导方针.
主要方法:
- 关于CAR T细胞治疗不良事件的已发表研究的文献综述.
- 对已报告的毒性机制的分析.
- 对毒性管理的当前临床指南的综合.
主要成果:
- 卡尔-T细胞治疗的毒性包括细胞因子释放综合征,神经毒性 (ICANS和非ICANS),血细胞淋巴细胞样性综合征和血液毒性.
- 这些毒性会导致长时间的细胞衰竭和感染风险增加.
- 在专门中心进行有效的监测和管理是必不可少的.
结论:
- 了解CAR T细胞治疗毒性的机制是有效管理的关键.
- 标准化的分级和管理协议是必要的,以减轻患者的风险.
- 需要继续进行研究,以进一步优化CAR T细胞疗法的安全性.
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