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柏林 - 汉诺威ICANS严重性评估 - 一个新的床边测试来评估与CAR T细胞相关的神经毒性
Lotta Völker1,2, Leonie Müller-Jensen3,4, Sophia Carl1
1Department of Neurology, Hannover Medical School, Hannover, Germany.
Frontiers in neurology
|February 6, 2026
概括
柏林-汉诺威ICANS严重性评估 (BHISA) 显示,与标准ICE得分相比,在CAR T细胞治疗患者中检测早期神经毒性的敏感性更高. 这种新工具有助于对免疫效应细胞相关神经毒性综合征 (ICANS) 的更细致的患者监测.
科学领域:
- 血液学和瘤学研究
- 神经科学是一个神经科学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 化学抗原受体 (CAR) T细胞疗法是对耐火性血液性恶性瘤的突破.
- 免疫效应细胞相关神经毒性综合征 (ICANS) 是CAR T细胞治疗的常见并发症.
- 目前的诊断工具,如免疫效应细胞相关脑病变 (ICE) 评分,对微妙的神经毒性缺陷缺乏敏感性.
研究的目的:
- 为了评估与ICE分数相比,新的柏林 - 汉诺威ICANS严重性评估 (BHISA) 的敏感性和诊断准确性.
- 确定BHISA是否可以在接受CAR T细胞治疗的患者中提供更早,更差异化的ICANS检测.
主要方法:
- 一项前性的双中心研究,涉及100名用CAR T细胞治疗的患者.
- 系统的神经评估使用ICE和BHISA在基线,输液后的6-7天和ICANS发作期间.
- 收集临床数据,毒性,并发症,CAR T细胞产品和ICANS治疗方法.
主要成果:
- 37%的患者患有ICANS,与细胞因子释放综合征和特定的CAR T细胞产物相关.
- 与ICE相比,BHISA表现出更广泛的分布和对微妙的神经变化更高的敏感性.
- BHISA的诊断准确度与ICE的诊断准确度相当 (AUC为0.783比0.777),但在匹配的特异性水平下,灵敏度始终更高.
结论:
- 比萨为ICANS提供了一个比ICE分数更敏感和差异化的选工具.
- 由于BHISA包含了额外的认知和运动领域,这有助于更早,更细致地检测与CAR T细胞相关的神经毒性.
- 在接受CAR T细胞治疗的异质人群中,BHISA可能会改善患者监测.
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