预先存在的自身免疫和化学抗原受体T细胞治疗毒性的癌症治疗之间的关联
Gregory J Challener1, Chen Wang2, David Gritsch3
1Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
ACR open rheumatology
|October 19, 2025
概括
接受CAR T细胞治疗癌症的自身免疫性疾病患者在医院住院时间更短,主要毒性减少. 这一发现为其在这个人群中使用提供了保证.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 血液学 血液学 血液学
背景情况:
- 化学抗原受体 (CAR) T细胞疗法对自身免疫性疾病具有前景.
- 关于在患有自身免疫性疾病的患者中使用CAR T细胞治疗的安全性,数据有限.
- 评估安全性对于扩大CAR T细胞治疗应用至关重要.
研究的目的:
- 评估先前存在的自身免疫性疾病与主要毒性或住院时间 (LOS) 之间的关联,在接受血液癌症CAR T细胞治疗的患者中.
主要方法:
- 使用国家住院样本数据 (2021-2022) 进行回顾性队列研究.
- 在先前患有或没有自身免疫性疾病的成年患者之间比较住院结果 (主要毒性,LOS,死亡率).
- 使用多变量回归模型,根据主要的人口和临床因素进行调整.
主要成果:
- 在1321名患者中,62名 (4.7%) 患有自身免疫性疾病.
- 患有自身免疫性疾病的患者住院时间显著缩短 (平均减少2.1天).
- 在患有自身免疫性疾病的患者中,重大毒性较少发生 (调整后几率比为0.55;95% CI为0.31-0.99). 住院患者的死亡率没有差异.
结论:
- 预先存在的自身免疫性疾病与较短的住院时间和较低的癌症CAR T细胞治疗后重大毒性风险有关.
- 这些发现为患有自身免疫疾病的患者的CAR T细胞治疗安全性提供了保证.
- 支持进一步研究用于治疗自身免疫性疾病的CAR T细胞疗法.
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