在多发性骨髓瘤患者中,细胞巨乳病毒的重新激活是常见的,这些患者接受了基于达拉图马布的治疗方案
Danilo De Novellis1,2, Raffaele Fontana1, Bianca Serio1
1Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
Cancer medicine
|July 22, 2024
概括
对多发性骨髓瘤 (MM) 的达拉图马布治疗显著增加了细胞巨核病毒 (CMV) 重活化的风险. 通过预防性治疗进行早期干预对于在这些免疫受损患者中管理CMV至关重要.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
背景情况:
- 由于免疫抑制,在血液病患者中病毒复激活是常见的.
- 多发性骨髓瘤 (MM) 的抗CD38抗体Daratumumab针对CD38表达淋巴细胞,增加免疫抑制.
- 在接受基于达拉图姆巴的治疗方案的MM患者中评估细胞巨乳病毒 (CMV) 重活化发生率至关重要.
研究的目的:
- 评估多发性骨髓瘤 (MM) 患者中细胞巨乳病毒 (CMV) 重激活的发生率,这些患者接受了基于达拉图马布的治疗方案.
- 为了比较daratumumab治疗和非daratumumab治疗的MM患者之间的CMV活性率.
主要方法:
- 一个单中心,双臂,现实生活研究包括101名连续MM患者.
- 患者被分为基于达拉图巴的和非基于达拉图巴的 (对照) 队列.
- 排除标准包括接受>2线治疗以尽量减少混因素的患者.
主要成果:
- 达拉图穆马布队列中的CMV再激活率明显高 (33%),而对照组 (4%).
- 在达拉图穆马布组 (12%>1000 IU/mL) 中观察到更高的CMV-DNA水平.
- 一名患者患上了CMV疾病,12%的患者接受了预防性瓦尔甘西克洛维尔,而没有对照患者需要抗CMV药物.
结论:
- 在多发性骨髓瘤患者中,达拉图穆马布治疗可能会显著增加CMV再激活的风险.
- 在接受治疗的MM患者中,CMV的活性被低估,并与发病率和死亡率有关.
- 通过更大规模的前性临床试验进行进一步验证是必要的,以证实这些发现.
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