营养不良和白血病与CAR T细胞治疗的不良结果有关,包括生存率
B Cucchiaro1, N A Davies2, C E Weekes2
1University College London, Division of Medicine, Rayne Institute, 5 University Street, London, WC1E 6BT, UK; University College London Hospital, Nutrition and Dietetics Department, 250 Euston Road, NW1 2PG, UK.
Clinical nutrition ESPEN
|June 20, 2024
概括
治疗前的营养不良和缓解症显著恶化了接受化学抗原受体 (CAR) T 细胞治疗的患者的结果,影响了生存率和增加了住院时间. 早期营养评估和干预对于优化患者护理至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 营养科学 营养科学
背景情况:
- 化学抗原受体 (CAR) T细胞疗法是B细胞恶性瘤的开创性治疗方法.
- 显著的挑战包括严重的毒性,复发,以及研究不足的问题,如缓冲症和营养不良.
- 了解营养状况对于改善CAR T细胞治疗结果至关重要.
研究的目的:
- 评估CAR T细胞患者的营养状况变化 (营养不良,缓解症).
- 调查营养状况对患者结局的影响,包括生存率.
- 描述这种患者群体的饮食资源的使用.
主要方法:
- 研究了在伦敦高等医疗中心接受针对CD19的CAR T细胞治疗的成年患者.
- 收集的数据包括体重,炎症标志物,营养分数和饮食输入.
- 用修改的格拉斯哥预后得分 (mGPS) 和全球营养不良领导倡议 (GLIM) 标准来评估营养状况.
主要成果:
- 在治疗前的营养不良影响了31.5%的患者;43.6%的患者患有前缓解症或耐火性缓解症 (mGPS).
- 改变营养状况与不良结果相关:生存率较低 (mGPS),住院时间增加,败血症和重症监护室入院.
- 在入院期间,68.4%的患者出现营养不良,并观察到显著的体重减轻.
结论:
- 治疗前的营养不良和缓解症与CAR T细胞治疗的较差结果有关.
- 卡切西亚状态 (mGPS) 独立预测了较低的整体存活率.
- 进一步的研究和饮食途径对于解决营养问题和优化患者治疗结果至关重要.
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