在CD-19化学抗原受体T细胞治疗后使用花细胞殖民地刺激因子的影响
Marshall D Winget1, Hunter Sowell2, Kendall Shultes3
1Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN.
Transplantation and cellular therapy
|September 15, 2025
概括
在CD-19 CAR-T细胞治疗后早期使用花细胞殖民地刺激因子 (G-CSF) 不会增加细胞因子释放综合征 (CRS) 或神经毒性风险. 这项研究质疑G-CSF.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- CD-19 CAR-T细胞疗法为B细胞恶性瘤提供了改善的结果.
- 卡特-T疗法与CRS和ICANS等毒性相关.
- 中性是常见的并发症,并且由于潜在的毒性风险,在CAR-T后使用G-CSF仍有争议.
研究的目的:
- 评估早期 (≤14天) 与晚期/不使用G-CSF对CAR-T治疗后CRS和ICANS发育的影响.
- 为了比较早期和晚期/没有G-CSF队列之间的中性质衰竭结果,包括持续时间和发病率.
主要方法:
- 对157名接受商业抗CD-19CAR-T治疗的成年患者进行了回顾性研究.
- 患者分为早期 (第一个G-CSF≤d+14) 和晚期/没有G-CSF队列.
- 主要结局:CRS和ICANS的发生率. 二级结局:中性质衰竭的严重程度,持续时间和中性质衰竭的发生率.
主要成果:
- 在调整后,早期和晚期/没有G-CSF组之间的CRS或ICANS发病率没有显著差异.
- 在早期组中,更高度的CRS更频繁,但在统计学上并不显著.
- 不过,中性衰竭的持续时间和发病率在各组之间是相似的.
结论:
- 在CAR-T后14天内使用G-CSF似乎不会增加CRS或ICANS的风险.
- 使用G-CSF并没有在改善中性质衰竭结果方面显示出显著的益处.
- 对于G-CSF在CAR-T后的中性质不良症管理中的实用性需要进一步研究.
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