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Blood:皮质醇用的越多,采用CAR T细胞疗法治疗的大B细胞淋巴瘤患者的预后越差!

2021-02-04 MedSci原创 MedSci原创

皮质类固醇的剂量、用药时间及持续时间是否会影响其临床疗效?

常采用皮质类固醇管理与嵌合抗原受体(CAR)T细胞疗法相关的重度毒性。然而,目前尚不明确皮质类固醇的剂量、用药时间及持续时间是否会影响其临床疗效。

本研究旨在明确皮质类固醇对采用标准抗CD19 CAR T细胞疗法治疗的复发性/难治性大B细胞淋巴瘤患者的临床预后的影响。

共评估了100位患者,其中60位(60%)接受了皮质类固醇控制CAR T细胞疗法相关毒性。地塞米松当量的中位累积剂量为186 mg(范围 8-1803 mg),皮质类固醇治疗的中位持续时间为9天(范围1-30天)。45位(75%)患者在前7天就开始使用皮质类固醇,有15位(25%)患者使用皮质类固醇超过了7天。

中位随访10个月(95% CI 8-12个月)后,皮质类固醇累积剂量使用的越多,无进展生存期明显越短。更重要的是,较高的皮质类固醇累积剂量,以及在输注CAR T细胞后早早使用皮质类固醇和延长皮质类固醇使用时间,都与总体生存期明显缩短有关。

综上所述,该研究结果表明,在管理CAR T细胞疗法相关毒性时,可以的情况下,皮质类固醇的使用,剂量应尽量小,应用时间应尽可能短,启用时间应尽可能晚。

原始出处:

Paolo Strati, et al. Prognostic Impact of Corticosteroids on Efficacy of Chimeric Antigen Receptor T-cell Therapy in Large B-cell Lymphoma. Blood. https://doi.org/10.1182/blood.2020008865

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    2021-05-15 陈SY

    博仁潘静医生文章还口口声声说卡提治疗过程中运用激素经验丰富,成熟。大家放心交给他们处理;不知道他们的“放心”研究结论怎么得出来的?

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Baidu
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Baidu
map