持久的单侧膜溢出与化学抗原受体T细胞透在一次性中枢大B细胞淋巴瘤中
Hiroyoshi Hayashi1, Masatoshi Sakurai1, Miki Sakamoto1
1Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan.
Internal medicine (Tokyo, Japan)
|October 8, 2025
概括
在CAR-T细胞治疗后持续的多叶膜溢出可能表明CAR-T细胞透. 这一案例凸显了流细胞计对诊断的重要性,并表明了潜在的自发解决方案,即使没有皮质类固醇.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 细胞疗法细胞疗法
背景情况:
- 胸腔溢液是已知的复杂症的奇默抗原受体 (CAR) T细胞治疗,通常是短暂的和双边的,与细胞因子释放综合征 (CRS) 相关.
- 耐药的初级中间体大B细胞淋巴瘤与膜参与呈现了一个具有挑战性的治疗场景.
研究的目的:
- 在CAR T细胞治疗后报告一个持续的单边大质量流病例.
- 为了调查CAR T细胞透作为持续性多叶流液的原因.
- 强调这种罕见并发症的诊断和管理策略.
主要方法:
- 一个34岁的男性的病例报告,他接受了Axicabtagene ciloleucel治疗,用于耐火性原发性中腺大B细胞淋巴瘤.
- 使用流式细胞计量来检测CAR T细胞透的胸腔液的分析.
- 临床监测输出溶解与或没有皮质类固醇治疗.
主要成果:
- 患者出现了持续的,单边的,大规模的肺溢液.
- 流式细胞计测证实,在多叶液中有显著的CAR T细胞透.
- 输液在用皮质类固醇时出现了暂时的改善,但在自发解决之前持续了几个月.
结论:
- 在CAR-T细胞治疗后持续的单侧外泄可能表明CAR-T细胞透.
- 流细胞计对于诊断在多叶流液中CAR T细胞透至关重要.
- 自发解决是可能的,这表明有潜在的警等待或降低皮质类固醇治疗的升级.
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