Pranav Pramod Patwardhan, Joseph Franz, Mounzer Agha, Bryan Rea
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引用次数: 0
摘要
目的:本研究试图分析抗 B 细胞成熟抗原(BCMA)嵌合抗原受体(CAR)T 细胞输注后的骨髓检查结果及其与全血细胞减少症的相关性:研究了 12 例接受抗 BCMA CAR T 细胞治疗的患者的相关临床病理数据,包括全血细胞计数、中性粒细胞计数、相关治疗史以及治疗前后的骨髓评估:结果:12 例患者中有 6 例在接受 CAR T 细胞疗法后进行了骨髓检查,其中 3 例患者的骨髓细胞明显减少,造血功能明显减弱或基本丧失。一个病例显示骨髓细胞减少,但有三系造血,其余两个病例显示浆细胞骨髓瘤持续受累。网织红细胞染色未发现明显的纤维化。治疗后第90天,10名患者出现贫血,8名患者出现白细胞和血小板减少。长期随访显示,12例患者中有10例病情持续存在:大多数患者在接受BCMA CAR T细胞治疗后会出现长期细胞减少症,骨髓评估显示相关的细胞明显减少,造血功能极低或没有,但纤维化没有增加。
Persistent cytopenias after anti-BCMA CAR T-cell therapy are associated with reduced hematopoietic activity in posttreatment bone marrows.
Objectives: We attempt to analyze bone marrow findings and correlation with cytopenia(s) after anti-B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell infusion in this study.
Methods: Relevant clinicopathologic data, including complete blood counts, neutrophil counts, relevant therapy history, and pre- and posttherapy bone marrow evaluations, were studied in 12 patients who received anti-BCMA CAR T-cell therapy.
Results: Bone marrow findings after CAR T-cell therapy were available in 6 of 12 cases, 3 of which showed markedly hypocellular marrow with either markedly reduced or essentially absent hematopoiesis. One case showed a hypocellular marrow with trilineage hematopoiesis, while the remaining 2 cases showed persistent involvement by plasma cell myeloma. Reticulin stains did not reveal significant fibrosis. Ten patients had anemia, and 8 patients had leukopenia and thrombocytopenia at day 90 posttherapy. Long-term follow-up showed persistent disease in 10 of 12 cases.
Conclusions: Prolonged cytopenias occur in most patients after BCMA CAR T-cell therapy with bone marrow evaluations demonstrating associated marked hypocellularity with minimal or no hematopoiesis without an increase in fibrosis.
期刊介绍:
The American Journal of Clinical Pathology (AJCP) is the official journal of the American Society for Clinical Pathology and the Academy of Clinical Laboratory Physicians and Scientists. It is a leading international journal for publication of articles concerning novel anatomic pathology and laboratory medicine observations on human disease. AJCP emphasizes articles that focus on the application of evolving technologies for the diagnosis and characterization of diseases and conditions, as well as those that have a direct link toward improving patient care.