Perspectives on outpatient administration of CAR-T cell therapy in aggressive B-cell lymphoma and acute lymphoblastic leukemia.
Perspectives on outpatient administration of CAR-T cell therapy in aggressive B-cell lymphoma and acute lymphoblastic leukemia.
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DOI：
10.1136/jitc-2020-002056
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发表时间：
2021-04
影响因子：
10.9
通讯作者：
Maziarz RT
中科院分区：
文献类型：
--
作者：
Myers GD;Verneris MR;Goy A;Maziarz RT
针对CD19抗原的嵌合抗原受体(CAR)T细胞疗法已成为难治性B细胞恶性血液病患者的一种高效治疗选择。来自关键的前瞻性临床试验的安全性和有效性结果，以及回顾、上市后和现实世界的分析，证实了在多个治疗路线失败且没有有意义的治疗选择的患者中，有高的应答率和持久的缓解。虽然最初是在住院环境中实施，但在门诊环境中提供CAR-T细胞疗法的兴趣越来越大；然而，由于包括后勤和报销问题在内的多种原因，这并未被采纳为标准的临床实践。CAR-T细胞治疗需要多学科的方法和协调，特别是在门诊环境下进行。密切监测患者的能力是必要的，必须建立适当的方案来对临床变化做出反应，以确保在临床或急诊科对发热、脓毒症、细胞因子释放综合征和神经事件，特别是免疫效应细胞相关神经毒性综合征的管理决策进行有效、有效和快速的评估。这篇综述介绍了作者在准备和提供门诊CD19导向的CAR-T细胞治疗方面的机构经验。
Chimeric antigen receptor (CAR) T-cell therapies that specifically target the CD19 antigen have emerged as a highly effective treatment option in patients with refractory B-cell hematological malignancies. Safety and efficacy outcomes from the pivotal prospective clinical trials of axicabtagene ciloleucel, tisagenlecleucel and lisocabtagene maraleucel and the retrospective, postmarketing, real-world analyses have confirmed high response rates and durable remissions in patients who had failed multiple lines of therapy and had no meaningful treatment options. Although initially administered in the inpatient setting, there has been a growing interest in delivering CAR-T cell therapy in the outpatient setting; however, this has not been adopted as standard clinical practice for multiple reasons, including logistic and reimbursement issues. CAR-T cell therapy requires a multidisciplinary approach and coordination, particularly if given in an outpatient setting. The ability to monitor patients closely is necessary and proper protocols must be established to respond to clinical changes to ensure efficient, effective and rapid evaluation either in the clinic or emergency department for management decisions regarding fever, sepsis, cytokine release syndrome and neurological events, specifically immune effector cell-associated neurotoxicity syndrome. This review presents the authors’ institutional experience with the preparation and delivery of outpatient CD19-directed CAR-T cell therapy.
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DOI：
10.1200/edbk_238693
发表时间：
2019-01-01
期刊：
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting
影响因子：
--
作者：
Abramson, Jeremy S;Lunning, Matthew;Palomba, M Lia
通讯作者：
Palomba, M Lia
影响因子：
20.3
作者：
Frigault, Matthew J.;Dietrich, Jorg;Maus, Marcela V.
通讯作者：
Maus, Marcela V.
影响因子：
168.9
作者：
Abramson, Jeremy S.;Palomba, M. Lia;Siddiqi, Tanya
通讯作者：
Siddiqi, Tanya
影响因子：
45.3
作者：
Lin, John K.;Muffly, Lori S.;Goldhaber-Fiebert, Jeremy D.
通讯作者：
Goldhaber-Fiebert, Jeremy D.
影响因子：
4.3
作者：
Lee, Daniel W.;Santomasso, Bianca D.;Neelapu, Sattva S.
通讯作者：
Neelapu, Sattva S.