互白素-6的联系:了解在CAR-T细胞治疗后细胞巨乳病毒的活性化
Linghao Li1,2, Zihao Wang1,2, Chongsheng Qian1,2
1National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
British journal of haematology
|November 12, 2025
概括
细胞巨乳病毒 (CMV) 活性化发生在26%的患者中,这些患者接受了化学抗原受体T细胞 (CAR-T) 治疗后的治疗. 在细胞因子释放综合征 (CRS) 期间高水平的互白素-6 (IL-6) 是CMV重新激活的关键风险因素.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 化学抗原受体T细胞 (CAR-T) 疗法已经彻底改变了血液恶性瘤的治疗方法.
- 细胞巨乳病毒 (CMV) 反激活是CAR-T治疗后已知的并发症,可能会影响患者的治疗结果.
- 了解CMV再激活的风险因素对于优化CAR-T治疗方案至关重要.
研究的目的:
- 研究在接受仿真抗原受体T细胞 (CAR-T) 治疗的患者中细胞巨乳病毒 (CMV) 反激活的发生率和危险因素.
- 确定与CMV复激活风险增加相关的特定临床参数.
- 阐明介质素-6 (IL-6) 在CAR-T免疫疗法后的CMV再激活中的作用.
主要方法:
- 对84名患有急性淋巴细胞白血病,非霍奇金淋巴瘤或多发性骨髓瘤的患者进行了回顾性分析,这些患者接受了CAR-T细胞治疗.
- 在CAR-T输注后监测细胞巨乳病毒 (CMV) 病毒性病.
- 统计分析以确定风险因素,包括细胞因子释放综合征 (CRS) 级别,CAR标,皮质类固醇剂量和INTERLEUKIN-6 (IL-6) 水平.
主要成果:
- 在84名患者中,22名患者 (26%),出现了细胞巨乳病毒 (CMV) 病毒病,中位时间到重新激活为15.5天.
- 持续高水平的IN-6 (IL-6) 被确定为CMV重新激活的重要危险因素.
- 其他危险因素包括3级以上的细胞因子释放综合征 (CRS),B细胞成熟抗原 (BCMA) 导向的CAR和高剂量的皮质类固醇.
结论:
- 细胞巨乳病毒 (CMV) 反激活是CAR-T细胞治疗后的常见并发症,在超过四分之一的患者中发生.
- 升高的干白素-6 (IL-6) 水平,特别是在细胞因子释放综合征 (CRS) 期间,与CMV重新激活密切相关.
- 这些发现凸显了监测IL-6和管理CRS的重要性,以减轻CAR-T治疗患者中CMV再激活风险.
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