在新型骨髓瘤治疗期间的感染
Alice J Liu1,2,3, Monica A Slavin1,2,3, Simon J Harrison2,3,4
1Department of Infectious Diseases, Peter MacCallum Cancer Centre, Parkville, Australia.
Leukemia & lymphoma
|November 18, 2024
概括
针对复发性/耐药性多发性骨髓瘤 (RRMM) 的新疗法,如双特异性抗体 (BsAb) 和CAR T细胞疗法,增加了感染风险. 本综述指导了这些患者的预防和抗微生物药物处方.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 新型疗法包括双特异性抗体 (BsAb),仿真抗原受体T细胞疗法 (CAR T) 和抗体药物合物 (ADC) 已经改变了复发性/耐药性多发性髓瘤 (RRMM) 治疗.
- 新出现的证据表明,与这些先进的治疗方法相关的感染风险增加.
研究的目的:
- 描述接受新型治疗的RRMM患者感染的流行病学.
- 为在这个脆弱的患者群体中提供预防和抗菌素处方指南.
- 确定感染预防策略的未来研究方向.
主要方法:
- 文献审查和临床试验和观察数据的分析.
- 感染模式,病原体和风险因素的表征.
- 综合有关感染风险机制的证据.
主要成果:
- 新型RRMM疗法与感染风险显著增加有关.
- 感染是由包括目标和非瘤效应 (细胞因子释放综合征,低血糖球蛋白血症,细胞衰竭),与疾病相关的免疫功能损害和先前治疗等因素驱动的.
- 细菌和病毒感染很常见,但潜在和机会性感染的重新激活也需要考虑.
结论:
- 了解与新型RRMM疗法相关的感染流行病学对于临床管理至关重要.
- 预防和治疗的抗微生物药物策略需要根据这些治疗所带来的特定风险进行调整.
- 需要进一步的研究,以优化接受尖端RRMM治疗的患者的感染预防和管理.
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