[CAR-T:在初级耐火患者中是一种有效的选择.]
Maria Chiara Tisi1, Michele Wieczorek1, Marcello Riva1
1UO Ematologia, Ospedale San Bortolo, Vicenza.
Recenti progressi in medicina
|February 20, 2026
概括
化学抗原受体T细胞 (CAR-T) 疗法,特别是axicabtagene ciloleucel (axi-cel),在治疗耐火性扩散性大B细胞淋巴瘤 (DLBCL) 中显示出显著的疗效. 早期治疗细胞因子释放综合征 (CRS) 和ICANS可确保治疗的安全性和有效性.
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:
- 扩散性大B细胞淋巴瘤 (DLBCL) 是一种常见的非霍奇金淋巴瘤.
- 化学抗原受体T细胞 (CAR-T) 疗法已成为复发性或耐火性DLBCL的有希望的治疗方法.
- 对DLBCL的标准一线治疗是R-CHOP,但耐火病例需要替代策略.
研究的目的:
- 报告一个 CAR-T 治疗成功的案例,在一个耐火性 DLBCL 的患者中使用 axi-cel.
- 突出免疫相关毒性的管理,包括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).
- 为了强调axi-cel在广泛和化学耐药性疾病中的安全性和有效性.
主要方法:
- 一名69岁的DLBCL耐R-CHOP治疗的女性患者接受了PolaBR和放射治疗的桥梁治疗.
- 进行了Axicabtagene ciloleucel (axi-cel) 的CAR-T疗法.
- 使用托西利祖马布治疗CRS,使用德甲治疗ICANS进行了治疗.
- 18F-FDG-PET扫描用于反应评估.
主要成果:
- 患者在轴细胞输液后一个月实现了完全缓解,由18F-FDG-PET扫描证实.
- 在输液后一年以上的时间内观察到持续的缓解.
- CRS和ICANS分别通过托西利祖马布和德甲成功管理,导致症状迅速消失.
结论:
- 艾克西卡巴丁基可乐塞尔 (axi-cel) 在患有广泛,症状和化学耐药的扩散性大B细胞淋巴瘤 (DLBCL) 的患者中表现出显著的疗效.
- 及时识别和管理CRS和ICANS等与免疫相关的毒性,对于患者的安全和治疗成功至关重要.
- 随着适当的安全监测,CAR-T疗法是挑战DLBCL病例的可行和有效选择.
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