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化学抗原受体T细胞疗法和免疫效应细胞相关的神经毒性综合征:元分析

Ashwini Thirugnanam¹, Karun Donthineni¹, Marco Mammi²

¹Department of Pharmaceutical Business and Administrative Sciences, School of Pharmacy, MCPHS, Boston, MA 02115, USA.

Critical reviews in oncology/hematology

|December 25, 2025

概括

化学抗原受体 (CAR) T细胞治疗血液性恶性瘤可以导致免疫效应细胞相关的神经毒性综合征 (ICANS). 蒂萨格纳cleucel和ciltacabtagene autoleucel在大B细胞淋巴瘤和多发性骨髓瘤中表现出更好的ICANS安全概况.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
血液学血液学血液学

背景情况:

化学抗原受体 (CAR) T细胞疗法是血液恶性瘤的关键治疗方法.
免疫效应细胞相关神经毒性综合征 (ICANS) 是CAR T细胞治疗的重要副作用.
在不同的CAR T细胞产品和患者群体中,ICANS的发生率和严重程度各不相同.

研究的目的:

为了确定ICANS在CAR T细胞治疗后的发病率和特征.
为了比较不同血液病和CAR T细胞产品之间的ICANS率.
为了识别ICANS风险的产品特定变化.

主要方法:

在PubMed,Embase和Cochrane图书馆进行了系统的文献搜索.
估计ICANS的聚合发病率和置信区间使用随机效应模型.
针对大型B细胞淋巴瘤 (LBCL),多发性骨髓瘤 (MM) 和地幔细胞淋巴瘤 (MCL) 进行了单独的元分析.

主要成果:

对30项研究的元分析 (审查了259篇文章) 显示了不同的ICANS发病率.
在LBCL中,tisagenlecleucel显示了较低的ICANS发病率 (16.5%),相比于axicabtagene ciloleucel (45.6%).
在MM中,ciltacabtagene autoleucel的ICANS发病率 (10.4%) 比idecabtagene vicleucel (18.3%) 低.
在MCL中,Brexucabtagene的自发细胞检测显示了高的整体ICANS发病率 (61.2%),严重事件略高于不那么严重的事件.

结论:

在LBCL和MM中,tisagenlecleucel和ciltacabtagene autoleucel似乎具有更有利的ICANS安全概况.
布雷克苏卡巴特基因自测表明,MCL患者的ICANS发病率较高.
需要进一步的研究来调整对比研究中的与治疗相关的混因素.

关键词:

在CAR T疗法治疗中.化学抗原受体T细胞治疗扩散大的B细胞淋巴瘤.在ICANS中,我们可以看到ICANS.免疫效应细胞相关的免疫效应细胞淋巴瘤是一种淋巴瘤.地膜细胞淋巴瘤是什么多发性骨髓瘤是一种多发性骨髓瘤.神经毒性综合征的神经毒性综合征

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