与CAR-T细胞治疗相关的蛋白尿和功能障碍的前性评估
Francesc Moncho-Francés1, Rafael Hernani2, Isabel Juan-García1
1Nephrology Department, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, Valencia, Spain.
Clinical kidney journal
|October 8, 2025
概括
化学抗原受体T细胞 (CAR-T) 治疗可能会导致临时脏问题,如蛋白尿和急性脏损伤 (AKI). 早期蛋白尿可能表明CAR-T治疗患者的结果更差,死亡率增加.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 化学抗原受体T细胞 (CAR-T) 治疗是一种新的癌症治疗方法.
- 毒性是CAR-T疗法的已知并发症,但尿路异常需要进一步描述.
研究的目的:
- 在接受CAR-T治疗的患者中表征蛋白尿,急性损伤 (AKI) 和电解质障碍.
- 为了研究蛋白尿和CAR-T治疗接受者的临床结果之间的关系.
主要方法:
- 对63名接受CAR-T治疗的患者进行前性分析.
- 每天进行血液检查和在输液日 (D0),+7 (D7) 和+14 (D14) 收集的尿样.
主要成果:
- 19%的患者患有AKI; 37%的患者在D7.7时蛋白尿 >0.5g/g.
- 蛋白尿与升高的LDH,IL-6和更高度细胞因子释放综合征 (CRS) 相关联.
- 95%的患者出现电解质障碍,最常见的是低血.
结论:
- 卡特-T疗法与过渡性脏不良影响有关,包括蛋白尿,AKI和电解质障碍.
- 系统性炎症驱动的管道损伤可能会导致CAR-T毒性.
- D0上的蛋白尿可能预测疾病进展和1年死亡率.
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