清晨好,您是今天最早来到科研通的研友!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您科研之路漫漫前行!

Haemophagocytic lymphohistiocytosis (HLH) in patients with large B-cell lymphoma treated with standard of care (SOC) axicabtagene ciloleucel (Axi-cel).

医学 内科学 噬血细胞性淋巴组织细胞增多症 噬血作用 背景(考古学) 胃肠病学 托珠单抗 细胞因子释放综合征 骨髓 肿瘤科 外科 癌症 嵌合抗原受体 免疫疗法 疾病 古生物学 生物 全血细胞减少症
作者
Sairah Ahmed,Fateeha Furqan,Paolo Strati,Jason R. Westin,Luis Fayad,Frederick Hagemeister,Hun Ju Lee,Swaminathan P. Iyer,Ranjit Nair,Loretta J. Nastoupil,Simrit Parmar,Maria Alma Rodriguez,Felipe Samaniego,Raphaël Steiner,Michael Wang,Chelsea C. Pinnix,Christopher R. Flowers,Sandra B. Horowitz,Misha Hawkins,Sattva S. Neelapu
出处
期刊:Journal of Clinical Oncology [American Society of Clinical Oncology]
卷期号:38 (15_suppl): 8057-8057 被引量:15
标识
DOI:10.1200/jco.2020.38.15_suppl.8057
摘要

8057 Background: HLH is a rare but serious complication of chimeric antigen receptor (CAR) T cell therapy, characterized by severe immune activation, and immune mediated multi-organ failure. Diagnosis is difficult in the context of cytokine release syndrome (CRS) and optimal treatment and outcomes are unclear. Methods: Retrospective, descriptive analysis of patients with relapsed/refractory LBCL treated with SOC axi-cel at MD Anderson Cancer Center between 01/2018 - 10/2019 (data cut-off 12/21/2019). Progression-free survival (PFS) defined as time from axi-cel infusion to progression/death or last follow-up. Diagnosis of HLH per HLH-2004 and CART cell therapy toxicity guidelines (Neelapu, 2018) Results: One hundred and five patients with relapsed/refractory LBCL included, 6 diagnosed with HLH. No significant difference in baseline characteristics, disease stage, international prognostic index or inflammatory markers at baseline between groups, with exception of platelet count which was lower in HLH group 116 [37-129] versus 141 [9-391] (p = 0.07). Development of HLH was early after CART cell infusion at a median 11 days [7 – 78 days] with 3 patients having bone marrow hemophagocytosis; all 6 had abnormalities in liver function tests, fibrinogen, triglycerides, and at least 1 ferritin level > 10,000. CART toxicity in HLH cohort: 4 patients experienced grade 0-1 CRS, and 1 with grade 2 CRS while 3 HLH patients experienced grade 3-4 IEC-associated neurotoxicity syndrome ( ICANS), and 2 patients had grade 0-1 ICANS. Five HLH patients treated with high dose steroids, and tocilizumab; anakinra administered in 2 patients. Four of 6 patients had resolution of HLH with treatment and didn’t require escalation to HLH specific therapy however 1 patient was treated with steroids/etoposide. PFS and overall survival (OS) were significantly shorter in HLH group, PFS 1 months vs 8 months, respectively (p < 0.001) and median OS 2 months vs not reached, respectively (p = 0.001) follow up 10 months (95% CI 8-12 months). One patient died of acute respiratory failure, 2 patients died of HLH and multi-organ failure without progressive disease (PD). Of 3 remaining patients, all had radiographic PD at day 30, 2 of whom died of PD. Conclusions: HLH is likely an underreported complication of CART cell therapy, and patients with HLH have significantly worse outcomes. In this series the majority of patients died of PD, not the syndrome itself. More information is necessary to design treatment strategies that won’t compromise CART outcomes.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Arthur完成签到 ,获得积分10
11秒前
研友_nxw2xL完成签到,获得积分10
32秒前
康康XY完成签到 ,获得积分10
36秒前
muriel完成签到,获得积分10
38秒前
有人应助科研通管家采纳,获得30
40秒前
有人应助科研通管家采纳,获得30
40秒前
闪闪的谷梦完成签到 ,获得积分10
1分钟前
范白容完成签到 ,获得积分10
3分钟前
肆肆完成签到,获得积分10
3分钟前
刘刘完成签到 ,获得积分10
4分钟前
JueruiWang1258完成签到,获得积分10
4分钟前
有人应助科研通管家采纳,获得10
4分钟前
有人应助科研通管家采纳,获得10
4分钟前
有人应助科研通管家采纳,获得10
4分钟前
有人应助科研通管家采纳,获得10
4分钟前
tingyeh完成签到,获得积分10
4分钟前
甜甜玫瑰应助baolong采纳,获得10
5分钟前
丹妮完成签到 ,获得积分10
5分钟前
liuzhigang完成签到 ,获得积分10
5分钟前
有人应助科研通管家采纳,获得10
6分钟前
有人应助科研通管家采纳,获得10
6分钟前
有人应助科研通管家采纳,获得10
6分钟前
有人应助科研通管家采纳,获得10
6分钟前
有人应助科研通管家采纳,获得10
6分钟前
baolong完成签到,获得积分10
6分钟前
jeff发布了新的文献求助30
7分钟前
姚老表完成签到,获得积分10
7分钟前
爆米花应助hani采纳,获得10
8分钟前
有人应助科研通管家采纳,获得10
8分钟前
有人应助科研通管家采纳,获得10
8分钟前
有人应助科研通管家采纳,获得10
8分钟前
有人应助科研通管家采纳,获得10
8分钟前
有人应助科研通管家采纳,获得10
8分钟前
有人应助科研通管家采纳,获得30
8分钟前
有人应助科研通管家采纳,获得10
8分钟前
thangxtz完成签到,获得积分10
9分钟前
李健应助zhangyimg采纳,获得10
9分钟前
云木完成签到 ,获得积分10
9分钟前
方白秋完成签到,获得积分10
9分钟前
yangquanquan完成签到,获得积分10
9分钟前
高分求助中
Evolution 10000
Sustainability in Tides Chemistry 2800
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
юрские динозавры восточного забайкалья 800
English Wealden Fossils 700
叶剑英与华南分局档案史料 500
Foreign Policy of the French Second Empire: A Bibliography 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3146771
求助须知:如何正确求助?哪些是违规求助? 2798063
关于积分的说明 7826669
捐赠科研通 2454589
什么是DOI,文献DOI怎么找? 1306394
科研通“疑难数据库(出版商)”最低求助积分说明 627708
版权声明 601527