文章：

接受CD19 CAR T细胞治疗的弥漫大B细胞淋巴瘤患者第一年内的感染情况

Infection during the first year in patients treated with CD19 CAR T cells for diffuse large B cell lymphoma

原文发布日期：2020-08-05

DOI: 10.1038/s41408-020-00346-7

类型: Article

开放获取: 是

英文摘要：

CD19-targeted chimeric antigen receptor (CAR) T cell therapy is an effective treatment for diffuse large B cell lymphoma (DLBCL). In addition to cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity (ICANS), B cell aplasia and hypogammaglobulinemia are common toxicities predisposing these patients to infections. We analyzed 60 patients with DLBCL treated with FDA-approved CD19 CAR T cells and report the incidence, risk factors, and management of infections during the first year after treatment. A total of 101 infectious events were observed, including 25 mild, 51 moderate, 23 severe, 1 life-threatening, and 1 fatal infection. Bacteria were the most common causative pathogens. The cumulative incidence of overall, bacterial, severe bacterial, viral, and fungal infection at 1 year were 63.3%, 57.2%, 29.6%, 44.7%, and 4%, respectively. In multivariate analyses, the use of systemic corticosteroids for the management of CRS or ICANS was associated with an increased risk of infections and prolonged admission. Impaired performance status and history of infections within 30 days before CAR T cell therapy was a risk factor for severe bacterial infection. In conclusion, infections were common within the first 60 days after CAR T cell therapy, however, they were not associated with an increased risk of death.
 

摘要翻译： 

CD19靶向的嵌合抗原受体（CAR）T细胞疗法是治疗弥漫大B细胞淋巴瘤（DLBCL）的有效方法。除了细胞因子释放综合征（CRS）和免疫效应细胞相关神经毒性综合征（ICANS）外，B细胞发育不全和低丙种球蛋白血症是常见的毒性反应，使这些患者易发生感染。我们分析了60例接受FDA批准的CD19 CAR T细胞治疗的DLBCL患者，并报告了治疗后第一年内感染的发生率、风险因素和管理。共观察到101起感染事件，包括25例轻度、51例中度、23例重度、1例危及生命和1例致命感染。细菌是最常见的致病病原体。一年内总体感染、细菌感染、严重细菌感染、病毒感染和真菌感染的累积发生率分别为63.3%、57.2%、29.6%、44.7%和4%。在多变量分析中，使用全身性皮质类固醇管理CRS或ICANS与感染风险增加和住院时间延长相关。功能状态受损和CAR T细胞治疗前30天内感染史是严重细菌感染的风险因素。总之，感染在CAR T细胞治疗后前60天内常见，但它们与死亡风险增加无关。

原文链接：

Infection during the first year in patients treated with CD19 CAR T cells for diffuse large B cell lymphoma