摘要
通过基因工程技术改造获得的表达嵌合抗原受体(chimeric antigen receptor,CAR)的T细胞有望成为血液系统恶性疾病治疗的新有效手段。嵌合抗原受体T细胞(CAR T cell,CAR-T)治疗B细胞恶性血液疾病可诱导产生快速和长期的临床反应,但也可能导致发生独特的急性毒性反应,甚至因此危及生命。细胞因子释放综合征(cytokine release syndrome,CRS)是CAR-T治疗的最常见毒性反应,严重程度从轻微反应直至危及生命的多器官功能障碍,严重的CRS可演变、发展成暴发性的噬血细胞性淋巴组织细胞增生症。CAR-T治疗的另一常见毒性反应是与CRS同时或在CRS之后发生的神经毒性,即CAR-T相关的脑病综合征。为了尽量降低CRS的发生率和死亡率,密切监测和迅速处理CRS相关的症状非常重要。本文概要介绍CRS的症状、分级和治疗。
T cells obtained by genetic engineering to express a chimeric antigen receptor（CAR） are rapidly emerging as a promising new treatment for haematological disease. CAR T cells（CAR-T） for the treatment of B cell malignant blood disease can induce rapid and durable clinical responses, however it is possible to cause unique acute toxic reactions or even death due to them. Cytokine release syndrome（CRS） is the most commonly observed toxicity and its severity can be from mild to life-threatening multiorgan dysfunction, in which severe CRS can evolve and develop into fulminant haemophagocytic lymphohistiocytosis. Another common toxic response to CAR-T therapy is the neurotoxicity termed CAR-T related encephalopathy syndrome, that occurs at the same time as CRS or after CRS. Intensive monitoring and prompt management of CRS-associated syndromes are essential to minimize the morbidity and mortality. Syndrome, grading and treatment of CRS are briefly introduced.
作者
周莉莉
李萍
梁爱斌
ZHOU Lili;LI Ping;LIANG Aibin(Department of Hematology,Tongji Hospital,Tongji University,Shanghai 200065,China)
出处
《上海医药》
CAS
2018年第11期9-14,20,共7页
Shanghai Medical & Pharmaceutical Journal
基金
上海市市级医院新兴前沿技术联合攻关项目(SHDC12015108)
