Late Effects after Chimeric Antigen Receptor T cell Therapy for Lymphoid Malignancies.
Late Effects after Chimeric Antigen Receptor T cell Therapy for Lymphoid Malignancies.
复制标题
嵌合抗原受体T细胞治疗类恶性肿瘤后的晚期效应。
DOI：
10.1016/j.jtct.2020.10.002
复制
发表时间：
2021-03
影响因子：
3.2
通讯作者：
Majhail NS
中科院分区：
文献类型：
--
作者：
Chakraborty R;Hill BT;Majeed A;Majhail NS
嵌合抗原受体T细胞[CAR T]疗法改变了复发性/难治性淋巴恶性肿瘤的治疗前景。随着CAR T细胞治疗后幸存者的不断扩大，晚期毒性的预防和管理正在成为生存护理的重要组成部分。本综述总结了淋巴恶性肿瘤CAR T细胞治疗后晚期毒性的证据现状。在临床试验和观察性研究中充分描述的晚期效应包括低丙种球蛋白血症、长期血细胞减少、晚期感染、神经系统和神经精神效应、免疫相关晚期效应和继发恶性肿瘤。低丙种球蛋白血症是CD 19导向的CAR T细胞治疗环境中最常见的晚期效应，这需要免疫球蛋白替代。晚期毒性的常见决定因素是年龄、潜在肿瘤类型、既往治疗、CAR构建体和急性毒性。在目前批准的适应症中，急性淋巴细胞白血病患者的低丙种球蛋白血症和长期血细胞减少的发生率高于侵袭性非霍奇金淋巴瘤患者。长期存活者的患者报告的身体和精神生活质量与一般人群相当，尽管迄今为止数据有限。本综述概述了该人群中晚期毒性的发生率、已知风险因素以及预防和管理策略。需要进一步的研究来描述基于人群的登记和正在进行的临床试验的长期随访的迟发效应的轨迹。
Chimeric Antigen Receptor T-cell [CAR T] therapy has changed the treatment landscape of relapsed/refractory lymphoid malignancies. With an expanding pool of post CAR T-cell therapy survivors, prevention and management of late toxicities is emerging as an important component of survivorship care. This review summarizes the current state of evidence on late toxicities after CAR T-cell therapy in lymphoid malignancies. Late effects that are well described in clinical trials and observational studies include hypogammaglobulinemia, prolonged cytopenias, late infections, neurologic and neuropsychiatric effects, immune-related late effects, and subsequent malignancies. Hypogammaglobulinemia is the most common late effect in the setting of CD19-directed CAR T-cell therapy, which necessitates immunoglobulin replacement. Common determinants of late toxicities are age, underlying tumor type, prior therapy, CAR construct, and acute toxicities. Among currently approved indications, the incidence of hypogammaglobulinemia and prolonged cytopenia is higher in patients with acute lymphoblastic leukemia compared to aggressive non-Hodgkin lymphoma. Patient-reported physical and mental quality of life in long-term survivors is comparable to general population, albeit, with limited data thus far. This review provides an overview of the incidence, known risk-factors, and strategies for prevention and management of late toxicities in this population. Further research is needed to characterize the trajectory of late effects from population-based registries and long-term follow-up of ongoing clinical trials.
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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：
4.8
作者：
Majhail NS;Rizzo JD;Lee SJ;Aljurf M;Atsuta Y;Bonfim C;Burns LJ;Chaudhri N;Davies S;Okamoto S;Seber A;Socie G;Szer J;Van Lint MT;Wingard JR;Tichelli A;Center for International Blood and Marrow Transplant Research;American Society for Blood and Marrow Transplantation;European Group for Blood and Marrow Transplantation;Asia-Pacific Blood and Marrow Transplantation Group;Bone Marrow Transplant Society of Australia and New Zealand;East Mediterranean Blood and Marrow Transplantation Group;Sociedade Brasileira de Transplante de Medula Ossea
通讯作者：
Sociedade Brasileira de Transplante de Medula Ossea
影响因子：
7.5
作者：
Maziarz, Richard T.;Waller, Edmund K.;Tam, Constantine S.
通讯作者：
Tam, Constantine S.
影响因子：
7.5
作者：
Jain, Tania;Knezevic, Andrea;Mailankody, Sham
通讯作者：
Mailankody, Sham
影响因子：
24
作者：
Alvi, Raza M.;Frigault, Matthew J.;Neilan, Tomas G.
通讯作者：
Neilan, Tomas G.