德国 CAR-T 细胞疗法患者的管理。

IF 2 4区 医学 Q3 ONCOLOGY
Oncology Research and Treatment Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI:10.1159/000536201
Olaf Penack, Peter Dreger, Salem Ajib, Francis Ayuk, Ben-Niklas Baermann, Gesine Bug, Oliver Kriege, Madlen Jentzsch, Guido Kobbe, Christian Koenecke, Mathias Lutz, Sonja Martin, Paul-Gerhard Schlegel, Roland Schroers, Bastian von Tresckow, Vladan Vucinic, Marion Subklewe, Wolfgang Bethge, Daniel Wolff
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引用次数: 0

摘要

背景:CAR-T细胞治疗已成为非霍奇金淋巴瘤和多发性骨髓瘤等复发或难治性血液系统恶性肿瘤的标准疗法。由于CAR-T细胞治疗领域进展迅速,且缺乏公认的治疗指南,我们假设各中心在短期和长期并发症的预防、诊断和管理方面存在显著差异:为了了解德国各中心目前的 CAR-T 细胞管理情况,确定医疗需求和未来临床研究的具体领域,DAG-HSZT(德国造血干细胞移植和细胞疗法工作组)对德国 26 家 CAR-T 细胞中心进行了调查:我们收到了来自 17 个中心(65%)的答复。调查显示,CAR-T 细胞领域的证据具有相关性,在已有临床证据的地区,实践具有同质性。与此相反,在没有临床证据或临床证据质量较低的领域,我们发现各中心之间的管理存在显著差异:细胞因子释放综合征(CRS)、免疫效应细胞相关神经毒性综合征(ICANS)、IgG替代、自体干细胞备份、抗感染预防和疫苗接种的管理:结果表明,迫切需要更好地协调CAR-T细胞疗法中的支持性护理,包括临床研究,以改善临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of Patients Undergoing CAR-T Cell Therapy in Germany.

Introduction: Chimeric antigen receptor positive T cell (CAR-T cell) treatment became standard therapy for relapsed or refractory hematologic malignancies, such as non-Hodgkin's lymphoma and multiple myeloma. Owing to the rapidly progressing field of CAR-T cell therapy and the lack of generally accepted treatment guidelines, we hypothesized significant differences between centers in the prevention, diagnosis, and management of short- and long-term complications.

Methods: To capture the current CAR-T cell management among German centers to determine the medical need and specific areas for future clinical research, the DAG-HSZT (Deutsche Arbeitsgemeinschaft für Hämatopoetische Stammzelltransplantation und Zelluläre Therapie; German Working Group for Hematopoietic Stem Cell Transplantation and Cellular Therapy) performed a survey among 26 German CAR-T cell centers.

Results: We received answers from 17 centers (65%). The survey documents the relevance of evidence in the CAR-T cell field with a homogeneity of practice in areas with existing clinical evidence. In contrast, in areas with no - or low quality - clinical evidence, we identified significant variety in management in between the centers: management of cytokine release syndrome, immune effector cell-related neurotoxicity syndrome, IgG substitution, autologous stem cell backups, anti-infective prophylaxis, and vaccinations.

Conclusion: The results indicate the urgent need for better harmonization of supportive care in CAR-T cell therapies including clinical research to improve clinical outcome.

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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
84
期刊介绍: With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.
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