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嵌合抗原受体 T 细胞治疗弥漫性大 B 细胞淋巴瘤患者外周血嗜酸性粒细胞计数对预后的影响。

Prognostic impact of peripheral eosinophil counts in patients with diffuse large B-cell lymphoma receiving chimeric antigen receptor T-cell therapy.

机构信息

Department of Hematology, Shanghai Tongji Hospital, Shanghai, China.

Department of Hematology, Shanghai Tongji Hospital, Shanghai, China.

出版信息

Cytotherapy. 2023 Jun;25(6):573-577. doi: 10.1016/j.jcyt.2022.10.010. Epub 2022 Nov 28.

Abstract

BACKGROUND AIMS

Chimeric antigen receptor (CAR) T-cell therapy is a breakthrough treatment for patients with relapsed or refractory diffuse large B-cell lymphoma. However, many patients do not achieve remission or relapse after remission. Previous studies have demonstrated that eosinophils have synergistic anti-tumor effects with CD8T cells and pre-CAR T-eosinophil counts are associated with the efficacy of CAR T cells.

METHODS

We retrospectively analyzed the eosinophil counts of patients with diffuse large B-cell lymphoma and found it changed remarkably pre- and post-CAR T-cell therapy.

RESULTS

Patients who achieved complete remission after CAR T-cell infusion had greater post-CAR T-eosinophil counts than those who did not. Kaplan-Meier curves showed that patients with greater eosinophil counts during the second month after CAR T-cell infusion had superior progression-free survival and overall survival compared with those with lower eosinophil counts.

CONCLUSIONS

For patients who responded to CAR T-cell therapy, eosinophil counts also can be used to predict 6-month duration of response. In conclusion, the post-CAR T-eosinophil count is associated with the prognosis of patients treated with CAR T-cell therapy and can be used to clinically identify patients who can achieve longer remission after CAR T-cell infusion.

摘要

背景目的

嵌合抗原受体 (CAR) T 细胞疗法是复发性或难治性弥漫性大 B 细胞淋巴瘤患者的突破性治疗方法。然而,许多患者在缓解后并未达到缓解或复发。先前的研究表明,嗜酸性粒细胞与 CD8T 细胞具有协同抗肿瘤作用,且预 CAR T-嗜酸性粒细胞计数与 CAR T 细胞的疗效相关。

方法

我们回顾性分析了弥漫性大 B 细胞淋巴瘤患者的嗜酸性粒细胞计数,发现其在 CAR T 细胞治疗前后变化显著。

结果

CAR T 细胞输注后达到完全缓解的患者的 CAR T 后嗜酸性粒细胞计数高于未达到完全缓解的患者。Kaplan-Meier 曲线显示,CAR T 细胞输注后第二个月嗜酸性粒细胞计数较高的患者与计数较低的患者相比,无进展生存期和总生存期更优。

结论

对于对 CAR T 细胞治疗有反应的患者,嗜酸性粒细胞计数也可用于预测 6 个月的反应持续时间。总之,CAR T 后嗜酸性粒细胞计数与接受 CAR T 细胞治疗的患者的预后相关,可用于临床识别 CAR T 细胞输注后可获得更长缓解期的患者。

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