Alice J Liu, Monica A Slavin, Simon J Harrison, Benjamin W Teh
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引用次数: 0
摘要
新一代疗法,如双特异性抗体(BsAb)、嵌合抗原受体 T 细胞疗法(CAR T)和抗体药物结合体(ADC),为复发性/难治性多发性骨髓瘤(RRMM)的治疗带来了革命性的变化。然而,在临床试验和观察环境中,有新的证据表明这些疗法会增加感染风险。这种感染风险可能是由靶向、肿瘤外副作用(如细胞因子释放综合征、低丙种球蛋白血症和细胞减少症)、与疾病相关的体液损伤以及先前多种治疗方法的后果所导致的。虽然细菌和病毒病原体占主导地位,但潜伏感染再活化和机会性感染也值得关注。本综述描述了与 RRMM 新型疗法相关的感染流行病学特征,以指导这类患者的预防和抗菌药物处方,并强调了未来的重点领域,为正在实施的感染预防策略提供依据。
New generation therapies such as bispecific antibodies (BsAb), chimeric antigen receptor T-cell therapy (CAR T) and antibody-drug conjugates (ADC) have revolutionized the treatment of relapsed/refractory multiple myeloma (RRMM). However, there is emerging evidence of increased infection risk associated with these treatments in clinical trials and observational settings. This infection risk may be mediated by on-target, off-tumor side effects such as cytokine release syndrome, hypogammaglobulinaemia and cytopenias, disease-related humoral impairment and the consequences of multiple previous lines of treatment. While bacterial and viral pathogens predominate, reactivation of latent infection and opportunistic infections also warrant attention. This review characterizes the epidemiology of infections associated with novel therapies for RRMM to guide prophylaxis and antimicrobial prescribing in this patient population and highlights future areas of focus to inform ongoing infection prevention strategies.
期刊介绍:
Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor