旧病原体-新型患者:CAR T细胞受体感染. 这可能会更复杂吗?
Monica Melchio1,2, Joshua A Hill3,4, Maunank Shah5,6
1Division of Infectious Diseases, Department of Health Sciences, University of Genova, Genova, Italy.
概括
这项病例研究详细介绍了一名患有淋巴瘤的患者,他患有COVID-19和结核病,延迟了CAR-T细胞治疗. 在接受治疗后, 他患上了严重的感染,
科学领域:
- 癌症学
- 传染性疾病
- 免疫疗法
背景情况:
- 一名41岁的男性患有中间膜扩散型大B细胞淋巴瘤是T细胞 (CAR-T) 治疗的候选人.
- 由于COVID-19复发和新发肺结核病导致治疗复杂化,需要延迟和抗菌治疗.
研究的目的:
- 描述因多种感染而复杂的淋巴瘤治疗的管理.
- 讨论CAR-T治疗时间和后续感染的管理方面的挑战.
- 为突出CAR-T治疗后侵袭性肺炎的治疗策略.
主要方法:
- 在接受CAR- T治疗之前,患者接受了11周的抗菌药物治疗.
- 在CAR-T后,该患者患有侵袭性肺阿斯伯吉洛症,并接受了伊萨武可纳和抗结核治疗.
- 治疗包括药物相互作用和长期治疗.
- 由于严重的血,进行了切术.
主要成果:
- 在治疗结核病后,CAR- T疗法得到了成功.
- 患者在CAR- T后出现了细胞因子释放综合征和免疫效应细胞相关的神经毒性综合征.
- 通过8个月的伊萨武科纳和抗结核疗法成功治疗了侵袭性肺.
- 严重的血需要切除.
结论:
- 这一案例凸显了接受CAR-T治疗并发性严重感染的患者管理的复杂性.
- 仔细考虑治疗时间,药物相互作用和长期抗菌疗法至关重要.
- 通过多学科治疗免疫受损患者的传染性并发症,可以获得成功的结果.
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