免疫效应细胞相关的神经毒性在化学抗原受体T细胞疗法后延迟复发:一个案例报告
Anna Favero1, Sara Mohamed2, Marta Lisa Battista3
1Neurology Unit, Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.
Neurology(R) neuroimmunology & neuroinflammation
|November 17, 2025
概括
本案例研究详细介绍了一种罕见的免疫效应细胞相关神经毒性综合征 (ICANS) 在CAR T细胞治疗后的晚期复发. 它表明ICANS可能具有双相过程,需要延长患者监测.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 神经科学是一个神经科学.
背景情况:
- 免疫效应细胞相关神经毒性综合征 (ICANS) 是CAR T细胞治疗的已知并发症.
- ICANS通常具有可变的发病期,通常被认为是单相性疾病.
研究的目的:
- 报告 CAR T 细胞治疗后发生的晚期ICANS复发的异常罕见病例.
- 突出与反复出现的ICANS相关的诊断和管理挑战.
主要方法:
- 一名为大B细胞淋巴瘤接受CAR T细胞治疗的患者在神经毒性方面受到密切监测.
- 临床评估,神经成像和实验室测试被用于跟踪症状进展,并为治疗决策提供信息.
主要成果:
- 患者在输液后14天经历了4级ICANS情节,昏迷,需要密集护理和用甲基prednisolone和anakinra治疗,导致恢复.
- 随后的3级ICANS复发发生在第40天,呈现出失方向性,共和,这些随着 levetiracetam,anakinra和dexamethasone而消失.
结论:
- 这一案例强调了超出传统时间框架的ICANS复发延迟的可能性,强调了长期患者监测的必要性.
- 这些发现表明ICANS的潜在双相模式,需要进一步调查其潜在的病理生理学和最佳的长期管理策略.
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