检查点抑制剂,CAR T细胞和静血系统:我们到目前为止知道了什么?
Christina C Rolling1, Samuel Lewirt1, Antonia Beitzen-Heineke1,2
1Department of Oncology, Hematology and BMT with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Hamostaseologie
|May 7, 2025
概括
免疫检查点抑制剂 (ICI) 和仿真抗原受体 (CAR) T 细胞可以导致危险的血栓和凝血问题. 了解这些风险至关重要,因为这些新型癌症疗法变得越来越普遍.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
背景情况:
- 免疫检查点抑制剂 (ICI) 和仿真抗原受体 (CAR) T 细胞是先进的免疫疗法,可促进抗癌T细胞反应.
- 这些疗法可以诱导高炎症,导致诸如细胞因子释放综合征 (CRS) 和自身免疫类症状等副作用.
- 新出现的证据将ICI与静脉和动脉血栓栓塞事件的风险增加联系在一起,关于CAR T细胞相关的凝血病的数据有限.
研究的目的:
- 审查与ICI和CAR T细胞疗法相关的血栓栓塞和凝血障碍的当前理解.
- 在这些免疫疗法的背景下,讨论与炎症相关的凝血激活背后的致病机制.
- 在接受T细胞导向癌症治疗的患者中探索静脉血栓栓塞 (VTE) 的潜在生物标志物.
主要方法:
- 对调查血栓栓塞并发症和凝血变化的研究的文献综述.
- 报告的不良事件的分析,包括细胞因子释放综合征 (CRS) 和传播性血管内凝血 (DIC).
- 讨论VTE的致病机制和潜在的预测生物标志物.
主要成果:
- ICI与静脉和动脉血栓栓塞事件的风险增加有关.
- 卡尔-T细胞疗法,特别是CRS,可以导致凝血病,低纤维素生成症是常见的,而DIC是一种罕见但严重的并发症.
- 现有的数据往往来自对异质患者群体的回顾性研究,这突显了需要进一步研究的需要.
结论:
- 血栓塞栓并发症和凝血病是ICI和CAR T细胞疗法的重要问题.
- 了解与炎症相关的凝血机制对于管理这些不良事件至关重要.
- 需要进一步的研究,包括前性研究和生物标志物识别,以减轻在接受基于T细胞的免疫疗法的患者的VTE风险.
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