Incidence and Risk Factors for Acute Kidney Injury After Chimeric Antigen Receptor T-Cell Therapy.
Incidence and Risk Factors for Acute Kidney Injury After Chimeric Antigen Receptor T-Cell Therapy.
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嵌合抗原受体t细胞治疗后急性肾损伤的发生率和危险因素。
DOI：
10.1016/j.mayocp.2022.05.018
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发表时间：
2022-07
影响因子：
8.9
通讯作者：
Herrmann, Sandra M.
中科院分区：
文献类型：
--
作者：
Farooqui, Naba;Sy-Go, Janina Paula T.;Miao, Jing;Mehta, Ramila;Vaughan, Lisa E.;Bennani, N. Nora;Wang, Yucai;Bansal, Radhika;Hathcock, Matthew A.;Hayman, Suzanne R.;Johnston, Patrick B.;Villasboas, Jose C.;Paludo, Jonas;Ansell, Stephen M.;Leung, Nelson;Lin, Yi;Herrmann, Sandra M.
评估CAR-T治疗后一个月内基线和后CAR-T患者特征与急性肾损伤（AKI）的关系。我们回顾性回顾了2016年6月至2020年11月期间接受CAR-T治疗（Axicabtagene-Ciloleucel）的83例NHL患者的记录。随访至治疗后1个月。CAR-T后AKI被定义为在CAR-T治疗后1个月的任何时间，血清肌酐（SCr）比基线（CAR-T输注当日）增加≥1.5倍。83例患者中有14例（17%）在随访期间发生AKI。CAR-T输注1个月后，10/14（71%）的患者AKI事件得到缓解。较低的基线肾小球滤过率（eGFR）、静脉造影剂的使用、肿瘤溶解预防、随访期间较高的尿酸和肌酸激酶（CK）峰值水平以及CAR-T治疗开始后1个月内乳酸脱氢酶（LDH）从基线到峰值水平的变化与随访期间AKI发病率显著相关。接受高剂量皮质类固醇和托珠单抗治疗的患者AKI的发生率也更高。在接受阿昔卡布他烯-西洛西尔治疗NHL的患者中，大约六分之一的患者发生AKI。接受更高总剂量皮质类固醇和/或托珠单抗的高肿瘤负荷患者应密切监测AKI的发展。CAR-T启动时较低的基线肾功能、造影剂暴露和CAR-T输注后肿瘤溶解标志物（尿酸、LDH、CK）水平的逐渐升高可能预测输注后1个月内AKI的风险。
To evaluate the association between baseline and post CAR-T patient characteristics and Acute Kidney Injury (AKI) in the month following CAR-T therapy. We retrospectively reviewed records of 83 NHL patients treated with CAR-T therapy (Axicabtagene-Ciloleucel) between June 2016 and November 2020. Patients were followed up to 1 month after treatment. Post CAR-T AKI was defined as a ≥1.5-fold increase in serum creatinine (SCr) from baseline (on the day of CAR-T infusion) at any time up to 1 month following CAR-T therapy. Fourteen (17%) of 83 patients developed AKI during follow-up. At 1 month post CAR-T infusion, 10/14 (71%) of patient AKI events had resolved. Lower baseline estimated glomerular filtration rate (eGFR), use of IV contrast, tumor lysis prophylaxis, higher peak uric acid and creatine kinase (CK) levels during follow-up and change in lactate dehydrogenase (LDH) from baseline to peak level within 1 month post initiation of CAR-T therapy were significantly associated with AKI incidence during follow-up. Incidence of AKI was also higher in patients who received higher doses of corticosteroids and Tocilizumab. AKI occurred in approximately 1 in 6 patients who received Axicabtagene-Ciloleucel for NHL. Patients with high tumor burden receiving higher total doses of corticosteroids and/or tocilizumab should be closely monitored for development of AKI. Lower baseline kidney function at CAR-T initiation, contrast exposure and progressive increase in levels of tumor lysis markers (uric acid, LDH, CK) following CAR-T infusion may predict risk of AKI during the 1-month post-infusion.
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影响因子：
13.2
作者：
Gupta, Shruti;Seethapathy, Harish;Sise, Meghan E.
通讯作者：
Sise, Meghan E.
影响因子：
3.9
作者：
Qu, Changju;Ping, Nana;Jin, Zhengming
通讯作者：
Jin, Zhengming
影响因子：
10.9
作者：
Myers GD;Verneris MR;Goy A;Maziarz RT
通讯作者：
Maziarz RT
DOI：
10.1038/mto.2016.11
发表时间：
2016
期刊：
Molecular therapy oncolytics
影响因子：
--
作者：
通讯作者：
--
影响因子：
8.8
作者：
Prochazka, Katharina T.;Melchardt, Thomas;Posch, Florian;Schlick, Konstantin;Deutsch, Alexander;Beham-Schmid, Christine;Weiss, Lukas;Gary, Thomas;Neureiter, Daniel;Klieser, Eckhard;Greil, Richard;Neumeister, Peter;Egle, Alexander;Pichler, Martin
通讯作者：
Pichler, Martin