概括
本综述解释了化学抗原受体T细胞疗法和癌症患者免疫检查点抑制剂的并发症. 对于管理这些先进治疗的重症监护临床医生来说,了解这些毒性至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 关键护理医学 关键护理医学
背景情况:
- 癌症患者占重症监护入院的15%.
- 化学抗原受体 (CAR) T细胞疗法和免疫检查点抑制剂 (ICI) 改善了癌症预后.
- 了解治疗并发症对于重症监护医生至关重要.
研究的目的:
- 为非专业人士提供关于CAR T细胞疗法和ICI相关毒性的理解.
- 审查这些并发症的病理生理学,诊断和管理.
- 突出目前管理免疫疗法诱导不良事件的概念.
主要方法:
- 在电子数据库中搜索同行评审的出版物.
- 包括基础科学,临床试验,队列研究,系统审查,元分析和指导方针.
- 选的摘要与免疫效应细胞毒性和与免疫相关的不良事件相关.
主要成果:
- 卡尔T细胞和ICI毒性的病理生理学尚未完全理解.
- 针对性治疗,如细胞因子释放综合征的治疗,是有效的.
- 皮质类固醇是管理的关键;诊断往往是临床的;感染性并发症需要保持警.
结论:
- 对免疫疗法毒性机制的理解有限,阻碍了预测模型和生物标志物.
- 需要进一步的研究,以开发尽量减少皮质类固醇使用的治疗方法.
- 管理需要重症监护和瘤专家之间的合作.
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