CAR - T细胞治疗后血液恶性肿瘤患者的癌症相关认知障碍：患病率的系统回顾和荟萃分析

IF 2.8 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-03-22 DOI:10.1007/s00520-025-09356-2

Mu-Hsing Ho, Denise Shuk Ting Cheung, Tongyao Wang, Lizhen Wang, Justin Wei Ho Wong, Chia-Chin Lin

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引用次数: 0

摘要

目的：肿瘤相关认知障碍是接受CAR - T细胞治疗的患者神经毒性症状之一。在短期和长期随访中，缺乏血液恶性肿瘤患者CAR -t细胞治疗后癌症相关认知障碍的总体估计患病率的证据。本综述旨在总结CAR - T细胞治疗后1个月、1 ~ 12个月和10 ~ 12个月的认知功能状况，并估计癌症相关认知功能障碍的患病率。方法：PubMed， Cochrane Library， EMBASE, CINAHL Plus, Web of Science， PsycINFO通过ProQuest从成立到2024年8月。研究报告的认知障碍患者接受CAR - T细胞治疗与有效措施纳入。使用随机效应模型汇总有关认知障碍患病率的数据。结果：共纳入16项研究，1407例患者。在随访时间点（12个月），使用神经心理学测试评估的癌症相关认知障碍患病率分别为24%[95%预测区间（PI） 16-33%]、33% （PI 9-64%）和35% （PI 23-48%）。使用其他方法评估的患病率估计值在不同时间点上从4%到38%不等。留一荟萃分析量化了这些潜在异常值对总体患病率估计的影响。结论：研究结果强调了在短期和长期随访期间制定有针对性的干预措施以预防或管理癌症患者认知障碍的重要性。这篇综述还强调了在这一领域进一步研究的必要性，以提高我们对疾病机制的理解，并实施预防策略来管理癌症相关的认知障碍。

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Cancer-related cognitive impairment in patients with hematologic malignancies after CAR T cell therapy: a systematic review and meta-analysis of prevalence.

Purpose: Cancer-related cognitive impairment is one of the symptoms of neurotoxicity among patients receiving chimeric antigen receptor (CAR) T cell therapy. Evidence of the overall estimated prevalence of cancer-related cognitive impairment following CAR T-cell therapy among patients with hematologic malignancies at short-term and long-term follow-ups is lacking. This review aimed to summarize the cognitive functioning status and estimate the prevalence of cancer-related cognitive impairment at follow-up within 1 month, 1 to 12 months, and > 12 months after CAR T cell therapy.

Methods: PubMed, Cochrane Library, EMBASE, CINAHL Plus, Web of Science, and PsycINFO via ProQuest from inception through August 2024. Studies that reported on cognitive impairment among patients receiving CAR T cell therapy with valid measures were included. Data on cognitive impairment prevalence were pooled using a random-effects model.

Results: In total, 16 studies involving 1407 patients were included. The pooled cancer-related cognitive impairment prevalence rates assessed using neuropsychological tests at the follow-up timepoints (< 1 month, 1-12 months, and > 12 months) were 24% [95% prediction interval (PI) 16-33%], 33% (95%, PI 9-64%), and 35% (95%, PI 23-48%), respectively. The prevalence estimates assessed using other measures were ranging from 4 to 38% across different timepoints. The leave-one-out meta-analyses quantified the impact of these potential outliers on the estimation of the overall prevalence.

Conclusions: The findings stress the importance of developing targeted interventions to prevent or manage cognitive impairment in cancer patients during both short-term and long-term follow-up periods. This review also highlights the need for further research in this area to improve our understanding of the disease mechanisms and implement preventive strategies for managing cancer-related cognitive impairment.

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.