大颗粒淋巴细胞驱动嵌合抗原受体-T 细胞并对类固醇产生反应后出现严重细胞减少。

IF 5.1 2区医学 Q1 HEMATOLOGY

British Journal of Haematology Pub Date : 2024-10-19 DOI:10.1111/bjh.19822

Antoine Capes, Alexandra Morin, Anne Banet, Ludovic Suner, Laure Ricard, Elise Corre, Eolia Brissot, Nicolas Stocker, Zora Marjanovic, Clémentine Sarkozy, Mohamad Mohty, Florent Malard

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引用次数: 0

摘要

免疫效应细胞相关血液毒性（ICAHT）是嵌合抗原受体（CAR）-T 细胞疗法后的一种常见毒性，也是一种重要的发病率。重症ICAHT的发生似乎与多种因素有关，因此治疗难度很大。在此，我们报告了三例弥漫大B细胞淋巴瘤阿昔单抗-伊洛琉醇（axicabtagene-ciloleucel，axi-cel）治疗后的重症ICAHT病例，其骨髓中大颗粒淋巴细胞增生，CD3/CD57阳性，免疫表型为非CAR-T。我们的研究表明，用小剂量类固醇治疗这些患者可以显著缓解细胞减少症，而且对潜在的恶性肿瘤没有任何有害影响。

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Severe cytopenia after chimeric antigen receptor-T cell driven by large granular lymphocytes and responsive to steroids.

Immune effector cell-associated hematotoxicity (ICAHT) is a common toxicity associated with an important morbidity after chimeric antigen receptor (CAR)-T-cell therapy. Multiple factors seem to be involved in the development of severe ICAHT, making its management difficult. Here, we report three cases of severe ICAHT after axicabtagene-ciloleucel (axi-cel) for diffuse large B-cell lymphoma showing an expansion of large granular lymphocyte in the bone marrow with a CD3/CD57-positive non-CAR-T immunophenotype. We show that it is possible to treat them with low-dose steroids, obtaining a striking resolution of cytopenias with no deleterious impact on the underlying malignancy.

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来源期刊

British Journal of Haematology 医学-血液学

CiteScore

8.60

自引率

4.60%

发文量

565

审稿时长

1 months

期刊介绍： The British Journal of Haematology publishes original research papers in clinical, laboratory and experimental haematology. The Journal also features annotations, reviews, short reports, images in haematology and Letters to the Editor.