| Autor: |
Dreyzin, Alexandra, Jacobsohn, David, Angiolillo, Anne, Wistinghausen, Birte, Schore, Reuven J., Perez, Evelio, Wells, Elizabeth, Terao, Joshua, Bonifant, Challice, Rohatgi, Radha, Dave, Hema, Vatsayan, Anant |
| Předmět: |
|
| Zdroj: |
Pediatric Hematology & Oncology; May2022, Vol. 39 Issue 4, p370-378, 9p |
| Abstrakt: |
CAR-T cells were not detectable in the blood sample for Patient 1, but for Patients 2 and 3, they were present at 30 days post-infusion, after treatment which included anakinra as well as corticosteroids. Chimeric antigen receptor-T (CAR-T) therapy has demonstrated impressive efficacy in B-cell malignancies, but its therapeutic index has been impaired by unique immune-mediated toxicities not seen with traditional cytotoxic chemotherapy.[1],[2] These toxicities include cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and hemophagocytic lymphohistiocytosis (HLH)-like syndrome.[2] Although IL-6 blockade with tocilizumab has become standard treatment for CRS, patients refractory to tocilizumab or those with ICANS often require corticosteroids. She was treated with bridging chemotherapy including cyclophosphamide, etoposide, vincristine, and dexamethasone, and then lymphodepleting therapy with fludarabine (30 mg/m SP 2 sp , 4 doses) and cyclophosphamide (500 mg/m SP 2 sp , 2 doses) prior to the CAR-T cell infusion. HT
|
