徐佳.嵌合抗原受体T细胞治疗并发感染的诊疗策略[J].内科急危重症杂志,2023,29(2):96-100
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| DOI：10.11768/nkjwzzzz20230202 |
| 中文关键词: 嵌合抗原受体T细胞治疗 感染 细菌 病毒 真菌 |
| 英文关键词: |
| 基金项目:国家自然科学基金（No:82070124）；中国初级卫生保健基金会中国CAR-T治疗综合管理-临床研究基金项目（No:CARTFR07） |
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| 中文摘要: |
| 嵌合抗原受体T(CAR-T)细胞疗法在治疗复发难治性血液恶性肿瘤中取得了显著的临床疗效，但治疗相关毒性仍不可忽视。感染作为CAR-T治疗中一大常见并发症，与治疗安全性密切相关。接受CAR-T细胞治疗的患者常因免疫功能低下和治疗相关毒性而容易并发感染，但在不同时间段、不同个体和群体间都存在感染特征的异质性。此外，细胞因子释放综合征与感染相似的临床表现进一步给感染的诊疗增加了难度。为了解决这一难题，本文总结归纳了CAR-T治疗早期监测和长期随访期间发生感染的类型与特征，并就CAR-T治疗期间感染的诊断防治提出相应策略。 |
| 英文摘要: |
| Chimeric antigen receptor(CAR)-T cell therapy has achieved significant clinical efficacy in treating relapsed and refractory hematologic malignancies, but treatment-associated toxicity still cannot be ignored. As a common complication of CAR-T cell therapy, infection is closely related to the treatment safety. Patients undergoing CAR-T cell therapy are susceptible to infections due to poor immune function and treatment-associated toxicities, but there is heterogeneity in infection characteristics during different time periods and among different individuals and populations. Besides, the similar clinical manifestations of cytokine release syndrome (CRS) with infection further increase the difficulty to diagnose and treat infections. To settle this problem, we summarize the categories and characteristics of infections during early monitoring and long-term follow-up of CAR-T cell therapy, and propose corresponding strategies for infection diagnosis, prophylaxis and treatment in this article. |
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