研究动态
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大B细胞淋巴瘤CAR-T细胞治疗后的非复发性死亡率:基于DESCAR-T注册表的LYSA研究。

Non-Relapse Mortality after CAR T-Cell therapy for Large B-Cell Lymphoma: A LYSA Study from the DESCAR-T Registry.

发表日期:2023 Sep 06
作者: Jean Lemoine, Emmanuel Bachy, Guillaume Cartron, David Beauvais, Thomas Gastinne, Roberta Di Blasi, Marie-Thérèse Rubio, Stéphanie Guidez, Mohamad Mohty, Olivier Casasnovas, Magalie Joris, Cristina Castilla-Llorente, Corinne Haioun, Olivier Hermine, Michael Loschi, Sylvain Carras, Pierre Bories, Tom Fradon, Charles Herbaux, Pierre Sesques, Steven Le Gouill, Franck Morschhauser, Catherine Thieblemont, Roch Houot
来源: CYTOKINE & GROWTH FACTOR REVIEWS

摘要:

CD19嵌合抗原受体(CAR)T细胞能够引发持久缓解,并有可能治愈大部分复发/难治性大B细胞淋巴瘤(LBCL)患者。然而,在CAR T细胞疗法后,部分患者可能因与淋巴瘤无关的原因而死亡。目前,我们对CAR T细胞后的非复发性死亡(NRM)了解甚少。本研究使用法国DESCAR-T登记表,分析了NRM的发生率、原因,并确定了NRM的危险因素。我们报告了957名接受标准护理治疗(SOC)axicabtagene ciloleucel(axi-cel;n=598)或tisagenlecleucel(tisacel;n=359)的患者,治疗时间为2018年7月至2022年4月,在法国27个中心进行。在中位随访12.4个月的情况下,共有48名患者(占所有患者的5.0%)发生了NRM:早期(<28天碰撞后)有9名患者(占所有患者的0.9%和总NRM的19%),晚期(≥28天碰撞后)有39名患者(占所有患者的4.1%和总NRM的81%)。总NRM的原因分布如下:56%的感染(29%的非COVID感染,27%的COVID感染),10%的细胞因子释放综合征(CRS),6%的中风,6%的脑出血,6%的第二原发恶性肿瘤,4%的免疫效应细胞相关的神经毒性(ICANS),以及10%的其他原因导致的死亡。我们报告了早期NRM和总NRM的危险因素。多变量分析显示,糖尿病和淋巴消融时升高的铁蛋白与总NRM的风险增加相关。我们的结果可以帮助医生在患者的选择和管理方面,以减少CAR T细胞疗法后的NRM。版权所有 © 2023 美国血液学会。
CD19 chimeric antigen receptor (CAR) T-cells can induce prolonged remissions and potentially cure a significant proportion of patients with relapsed/refractory (r/r) large B-cell lymphomas (LBCL). However, some patients may die of causes unrelated to lymphoma after CAR T-cell therapy. To date, little is known about the non-relapse mortality (NRM) following CAR T-cells. Using the French DESCAR-T registry, we analyzed the incidence and causes of NRM, and identified risk factors of NRM. We report 957 patients who received standard-of-care (SOC) axicabtagene ciloleucel (axi-cel; n=598) or tisagenlecleucel (tisacel; n=359) between July 2018 and April 2022, in 27 French centers. With a median follow-up of 12.4 months, overall NRM occurred in 48 patients (5.0% of all patients): early (