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嵌合抗原受体 T 细胞治疗后 B 细胞血液系统恶性肿瘤患者细胞因子释放综合征的预后意义。

Prognostic Significance of Cytokine Release Syndrome in B Cell Hematological Malignancies Patients After Chimeric Antigen Receptor T Cell Therapy.

机构信息

Department of Hematology, Wenzhou Key Laboratory of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Laboratory Animal Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

J Interferon Cytokine Res. 2021 Dec;41(12):469-476. doi: 10.1089/jir.2021.0057.

Abstract

Cytokine release syndrome (CRS) is the most common on-target toxicity of chimeric antigen receptor (CAR) T cell therapy. However, the prognostic significance of CRS has not been well elucidated. The aim of our study was to evaluate the association between CRS and efficacy after anti-CD19 CAR-T therapy in a retrospective cohort of 22 patients with relapsed/refractory B cell hematological malignancies. The complete remission (CR) rates after CAR-T therapy were 68%, and median value for progression-free survival (PFS) was 6.8 months. Eight of 22 (36.4%) patients showed ≥ grade 2 CRS. Statistical analysis found that patients with ≥ grade 2 CRS had higher CR rates and longer PFS than those with < grade 2 CRS. Moreover, bridging hematopoietic stem cell transplantation was another independent predictor for PFS. These data suggested that appropriate CRS may be beneficial to the efficacy of CAR-T therapy. The Clinical Trial Registration number is NCT03110640, NCT03302403.

摘要

细胞因子释放综合征(CRS)是嵌合抗原受体(CAR)T 细胞治疗最常见的靶毒性。然而,CRS 的预后意义尚未得到很好的阐明。我们的研究目的是在 22 例复发/难治性 B 细胞血液恶性肿瘤患者的回顾性队列中评估 CRS 与抗 CD19 CAR-T 治疗后疗效之间的关系。CAR-T 治疗后的完全缓解(CR)率为 68%,无进展生存(PFS)的中位值为 6.8 个月。22 例患者中有 8 例(36.4%)出现≥2 级 CRS。统计分析发现,≥2 级 CRS 患者的 CR 率更高,PFS 更长。此外,桥接造血干细胞移植是 PFS 的另一个独立预测因素。这些数据表明,适当的 CRS 可能有利于 CAR-T 治疗的疗效。临床试验注册号为 NCT03110640,NCT03302403。

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