在复发/逆转性B细胞淋巴瘤中进行CAR-T细胞疗法后的血小板和纤维素原动力学可能预测ICANS发病
Hazim Khatib1, Amit Parizat2, Jabour Halloun1
1Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
European journal of haematology
|February 13, 2026
概括
在CAR-T疗法中预测免疫效应细胞相关神经毒性综合征 (ICANS) 是至关重要的. 血小板和纤维素原水平的变化可能成为淋巴瘤患者ICANS发展的早期预警信号.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 卡尔-T细胞疗法在复发/耐药B细胞淋巴瘤中显示出有效性.
- 细胞因子释放综合征 (CRS) 和免疫效应细胞相关的神经毒性综合征 (ICANS) 是CAR-T疗法的重要并发症.
- 预测和预防ICANS对于患者安全至关重要.
研究的目的:
- 调查凝血参数动态对ICANS发展的预测价值.
- 在接受CAR-T治疗的B细胞淋巴瘤患者中分析凝血标志物和ICANS之间的关系.
主要方法:
- 在两个三级医疗中心对265名B细胞淋巴瘤患者的回顾性分析.
- 每天监测血小板计数,纤维素原,PT,PTT,INR和D-二次体,从淋巴损失前到输液后2周.
- 具有和没有ICANS的患者之间的凝血参数的比较,包括高度事件.
主要成果:
- ICANS发生在34%的患者中;高度ICANS发生在13%的患者中.
- 患有ICANS的患者显示血小板和纤维素原水平的中位数显著降低.
- 在高度ICANS发作之前,观察到血小板数量显著下降和纤维素素水平变化.
结论:
- 血小板和纤维素原动态可以作为淋巴瘤患者ICANS发展的早期指标.
- 监测凝血参数可能有助于在CAR-T治疗后预测和管理ICANS.
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