[CAR-T细胞免疫疗法在引入化学免疫疗法后早期复发.]
Livia Donzelli1, Alice Di Rocco1
1Ematologia, Dipartimento di Medicina traslazionale e di precisione, Sapienza Università di Roma.
Recenti progressi in medicina
|February 20, 2026
概括
一名患有复发性大B细胞淋巴瘤的患者在接受了axicabtagene ciloleucel (axi-cel) CAR-T疗法作为二线治疗后,获得了持续的完整代谢反应. 这一案例突出了高风险患者中axi-cel的疗效和可控毒性.
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:
- 大型B细胞淋巴瘤 (LBCL) 是一种严重的血液性恶性瘤.
- 卡特-T疗法,特别是基基 (axicabtagene ciloleucel (axi-cel)) 已经成为一个关键的治疗选择.
- 对于早期复发的患者来说,二线治疗决策至关重要.
研究的目的:
- 介绍一个患有复发性LBCL的患者的病例研究,该患者接受了轴细胞CAR-T疗法.
- 评估axi-cel作为二线治疗的疗效和安全性.
- 强调在高风险的LBCL患者中及时进行CAR-T治疗的重要性.
主要方法:
- 一名66岁的女性患者患有第四阶段LBCL和高疾病负担.
- 使用R-CHOP的第一线治疗导致完全缓解,随后在6个月后出现早期复发.
- 患者接受了白血,一个周期的R-DHAP,随后是轴细胞CAR-T疗法.
主要成果:
- 患者在R-DHAP后获得了部分反应,随后接受了轴细胞.
- 观察并管理了轻度1级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).
- 治疗后1,3个月和6个月的正子发射断层扫描 (PET) 扫描证实了完整的代谢反应,该反应仍在进行中.
- 没有报告长期毒性.
结论:
- 艾克西卡巴丁基可乐塞尔 (axi-cel) 证明了作为二线CAR-T治疗复发的大B细胞淋巴瘤的显著疗效.
- 治疗与可管理的CRS和ICANS有关,这表明了有利的安全性.
- 密切监测患者和及时考虑CAR-T治疗对于改善高风险LBCL患者的结果至关重要.
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