在CAR T细胞治疗后的呼吸道同胞性病毒:多中心回顾性队列中的风险因素和结果
Maria Isabel Sotelo-Alva1,2, Ofrat Beyar-Katz3, Judy Yan4
1Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, United States.
概括
在7%的CAR-T治疗患者中发生了呼吸道同胞性病毒 (RSV) 感染,有些人进展到下呼吸道感染. 警至关重要,特别是在RSV季节,因为感染往往会在治疗后出现.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 化学抗原受体 (CAR) T细胞疗法是血液恶性瘤的重要治疗方法.
- 接受CAR-T治疗的患者免疫力低下,增加了对感染的易感性.
- 呼吸道共囊病毒 (RSV) 对免疫功能低下的人群构成重大威胁.
研究的目的:
- 为了确定接受CAR-T治疗的患者RSV感染的发病率和结果.
- 确定与CAR-T后严重RSV疾病 (LRTI) 相关的风险因素.
- 为了描述RSV感染的时间在这个脆弱的患者队列.
主要方法:
- 对接受CAR-T治疗的667名患者的回顾性分析.
- 监测RSV诊断和下呼吸道感染 (LRTI) 的发展.
- 统计分析以确定与RSV严重程度和时间相关的因素.
主要成果:
- 在667名CAR-T接受者中,RSV的2年累计发病率为7%.
- 在被诊断的RSV病例中,29%的病例进展为LRTI.
- 高龄和淋巴衰竭与RSV严重程度的增加有关.
- 大多数感染 (74%) 发生在CAR-T后100天 (中位数为8个月) 之后.
- 没有直接归因于RSV的死亡.
结论:
- 在CAR-T接受者中,RSV感染是显著的并发症,其中很大一部分患有LRTI.
- 晚期发病的感染很常见,需要长时间的临床警.
- 风险因素,如老年和淋巴缺血,应指导监测和预防策略.
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