嵌合抗原受体 T 细胞治疗并发症的新治疗方式：病例报告。
Novel Treatment Modality for Chimeric Antigen Receptor T-cell Therapy Complications: A Case Report.
发表日期：2024 Jul
作者：
Dianella Rente Lavastida, Samantha De Filippis, Eliu G Rivera Torres, Alexander Aldanese, Samir Ruxmohan
来源：
CYTOKINE & GROWTH FACTOR REVIEWS
摘要：
免疫细胞相关神经毒性综合征 (ICANS) 和细胞因子释放综合征 (CRS) 都是嵌合抗原受体 (CAR) T 细胞治疗的常见副作用。 Blinatumomab 是 B 细胞急性淋巴细胞白血病 (B-ALL) 患者常用的 CAR T 细胞治疗方法。我们的患者有丰富的既往病史，包括难治性 B-ALL，并在接受 blinatumomab CAR-T 细胞疗法治疗后出现 CRS 和 ICANS。 ICANS 的早期临床检测、使用免疫效应细胞脑病评分进行监测、遵循 ICANS 分级的适当方案以及添加阿那白滞素（IL-1 受体拮抗剂）是控制其病情的关键步骤。 管理和监测该患者的方法是独特的，因为我们将阿那白滞素添加到标准治疗方案中。通过这份报告，我们强调需要对 CAR T 细胞治疗方案以及如何降低其不良反应的发病率和死亡率进行进一步研究。版权所有 © 2024，Rente Lavastida 等人。
Immune cell-associated neurotoxicity syndrome (ICANS) and cytokine release syndrome (CRS) are both common adverse effects of chimeric antigen receptor (CAR) T-cell therapy. Blinatumomab is a commonly used CAR T-cell treatment in patients with B-cell acute lymphoblastic leukemia (B-ALL). Our patient presented with an extensive past medical history, including refractory B-ALL, and developed CRS and ICANS following treatment with blinatumomab CAR-T cell therapy. Early clinical detection of ICANS, monitoring using immune effector cell encephalopathy scores, following the appropriate protocol for ICANS grade, and adding anakinra (IL-1 receptor antagonist) were crucial steps in managing his condition. The approach to managing and monitoring this patient was unique in that we added anakinra to the standard treatment regimen. With this report, we emphasize the need for further research regarding CAR T-cell therapeutic regimens and how to decrease the morbidity and mortality of its adverse effects.Copyright © 2024, Rente Lavastida et al.