用CD19CAR-T疗法治疗的侵袭性B细胞淋巴瘤患者的静脉血栓栓塞:单一机构研究
Neha Venkatesh1, Kevin Milligan1, Julia Parrish1
1Baylor College of Medicine Houston Texas USA.
EJHaem
|February 2, 2026
概括
接受CAR-T治疗的大型B细胞淋巴瘤 (LBCL) 患者面临着静脉血栓塞栓症 (VTE) 的显著风险,特别是在第一个月内. 高度的神经毒性和特定的LBCL亚型与增加的VTE事件有关.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫疗法是一种免疫疗法.
背景情况:
- 大型B细胞淋巴瘤 (LBCL) 是非霍奇金淋巴瘤的一个重要群体.
- 化学抗原受体T细胞 (CAR-T) 疗法改变了LBCL治疗,提供了高缓解率,但也呈现了诸如细胞因子释放综合征 (CRS) 和免疫效应细胞相关神经毒性综合征 (ICANS) 等毒性.
- 在接受CAR-T治疗的患者中,静脉血栓塞栓症 (VTE) 的风险和特征仍未得到充分研究.
研究的目的:
- 为了确定LBCL患者在CAR-T治疗后急性VTE的发病率和临床特征.
- 为了确定与VTE发展相关的基线临床因素.
- 评估VTE活动的时间和共同地点.
主要方法:
- 对172名接受CAR-T治疗的成人LBCL患者的回顾性审查.
- 数据收集包括人口统计,临床特征和不良事件.
- 在CAR-T后六个月内发生的VTE事件通过诊断成像证实;统计分析包括单变量分析和累积发病率函数.
主要成果:
- 6个月VTE发病率为7.6%,主要影响中央静脉导管的上肢.
- VTE与特定疾病组织学 (p=0.033) 和高等级ICANS (p=0.013) 有意义地相关.
- 原发性中性B细胞淋巴瘤 (PMBCL) 患者与扩散性大B细胞淋巴瘤 (DLBCL) 和T细胞丰富/毛囊性淋巴瘤 (TFL) 相比,表现出更高的VTE发病率 (30%),大多数事件发生在第一个月内.
结论:
- 接受CAR-T治疗的LBCL患者具有显著的VTE风险,特别是在治疗后的第一个月内.
- 患有PMBCL的患者和那些经历高度ICANS患者的风险增加.
- 这些发现强调了对这种患者群体的静脉血栓预防策略的进一步调查的必要性.
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