To the Editor:After chimeric antigen receptor T(CAR-T)cell therapy,over 90%of patients experience either mild or severe cytopenia,with the prevalence of Grades 3–4 neutropenia ranging from 53%to 94.3%.[1,2]Granulocyt...To the Editor:After chimeric antigen receptor T(CAR-T)cell therapy,over 90%of patients experience either mild or severe cytopenia,with the prevalence of Grades 3–4 neutropenia ranging from 53%to 94.3%.[1,2]Granulocyte colony-stimulating factor(G-CSF),known for its ability to enhance the proliferation and differentiation of neutrophils,has been extensively employed for the prevention and treatment of neutropenia in various contexts.However,its application in patients with refractory/relapsing B-cell acute lymphoblastic leukemia(R/R B-ALL)after CAR-T cell therapy remains a topic of debate.[3]Several studies have suggested that G-CSF may exert anti-inflammatory effects by modulating the release of inflammatory factors,such as interleukin-12(IL-12),TNF-α,and IFN-γ,or by influencing the differentiation of T-cell subsets.[4]However,other researchers have posited that G-CSF could exacerbate cytokine release syndrome(CRS)and immune effector cell-associated neurotoxicity syndrome(ICANS)through the augmentation of antigen-presenting cell function.展开更多
基金supported by grants from the General Project of the National Natural Science Foundation of China(No.81970180)the Science and Technology Project of Tianjin Municipal Health Committee(No.TJWJ2022QN030)+7 种基金the Key projects of Tianjin Applied Basic Research and Multi-Investment Fund(No.21JCZDJC01240)the Science and Technology Project of Tianjin Municipal Health Committee(No.TJWJ2022XK018)Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-056B)Tianjin Municipal Natural Science Foundation(No.22JCQNJC00820)Tianjin Health Research Project(No.TJWJ2023QN027)Tianjin Health Bureau Project(No.ZC20074)Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJWJ2023XK010)Henan Provincial Youth and Middle-aged Health Science and Technology Talents Excellent Youth Program(No.20230273).
文摘To the Editor:After chimeric antigen receptor T(CAR-T)cell therapy,over 90%of patients experience either mild or severe cytopenia,with the prevalence of Grades 3–4 neutropenia ranging from 53%to 94.3%.[1,2]Granulocyte colony-stimulating factor(G-CSF),known for its ability to enhance the proliferation and differentiation of neutrophils,has been extensively employed for the prevention and treatment of neutropenia in various contexts.However,its application in patients with refractory/relapsing B-cell acute lymphoblastic leukemia(R/R B-ALL)after CAR-T cell therapy remains a topic of debate.[3]Several studies have suggested that G-CSF may exert anti-inflammatory effects by modulating the release of inflammatory factors,such as interleukin-12(IL-12),TNF-α,and IFN-γ,or by influencing the differentiation of T-cell subsets.[4]However,other researchers have posited that G-CSF could exacerbate cytokine release syndrome(CRS)and immune effector cell-associated neurotoxicity syndrome(ICANS)through the augmentation of antigen-presenting cell function.
