Neurotoxicity Associated with CD19-Targeted CAR-T Cell Therapies.
Neurotoxicity Associated with CD19-Targeted CAR-T Cell Therapies.
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DOI：
10.1007/s40263-018-0582-9
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发表时间：
2018-12
期刊：
影响因子：
6
通讯作者：
Turtle CJ
中科院分区：
文献类型：
--
作者：
Gust J;Taraseviciute A;Turtle CJ
神经毒性是嵌合抗原受体-T细胞治疗的一个重要和常见的并发症。在接受CD19指导的嵌合抗原受体-T细胞治疗的B细胞恶性肿瘤患者中，有相当大一部分患者会出现急性神经系统症状和/或症状。临床表现包括头痛、神志不清、神志不清、语言障碍、癫痫发作，极少出现急性脑水肿。神经毒性与细胞因子释放综合征有关，细胞因子释放综合征发生在体内嵌合抗原受体-T细胞活化和增殖的背景下。导致神经毒性的机制尚不清楚，但来自患者和动物模型的数据表明，血脑屏障受到损害，与血液和脑脊液中高水平的细胞因子以及内皮激活有关。皮质类固醇、白介素6靶向治疗和支持性护理经常用于治疗神经毒性患者，但缺乏关于其有效性的高质量证据。
Neurotoxicity is an important and common complication of chimeric antigen receptor-T cell therapies. Acute neurologic signs and/or symptoms occur in a significant proportion of patients treated with CD19-directed chimeric antigen receptor-T cells for B-cell malignancies. Clinical manifestations include headache, confusion, delirium, language disturbance, seizures and rarely, acute cerebral edema. Neurotoxicity is associated with cytokine release syndrome, which occurs in the setting of in-vivo chimeric antigen receptor-T cell activation and proliferation. The mechanisms that lead to neurotoxicity remain unknown, but data from patients and animal models suggest there is compromise of the blood–brain barrier, associated with high levels of cytokines in the blood and cerebrospinal fluid, as well as endothelial activation. Corticosteroids, interleukin-6-targeted therapies, and supportive care are frequently used to manage patients with neurotoxicity, but high-quality evidence of their efficacy is lacking.
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影响因子：
20.3
作者：
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通讯作者：
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影响因子：
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影响因子：
45.3
作者：
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