供者来源嵌合抗原受体T细胞治疗后继发慢性移植物抗宿主病2例报告并文献复习  

Chronic graft-versus-host disease secondary to donor-derived chimeric antigens receptor-T cell treatment in children:report of two cases and literature review

作　　者：陈凯[1] 程翼飞[4] 夏敏[2] 王雪莉[3] 张娜[1] 邵静波[1] 朱嘉莳[1] 李红[1] 刘青[1] 蒋慧[1] CHEN Kai;CHENG Yifei;XIA Min;WANG Xueli;ZHANG Na;SHAO Jingbo;ZHU Jiashi;LI Hong;LIU Qing;JIANG Hui(Department of Hematology and Oncology,Shanghai Children′s Hospital,Shanghai JiaoTong University,Shanghai 200040,China;Department of Hematology,Peking University People′s Hospital,Peking University Institute of Hematology,Beijing 100044,China;Clinical Laboratory,Shanghai Children′s Hospital,Shanghai JiaoTong University,Shanghai 200040,China;Department of Pathology,Shanghai Children′s Hospital,Shanghai JiaoTong University,Shanghai 200040,China)

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院血液肿瘤科,上海200040 [2]上海市儿童医院,上海交通大学附属儿童医院检验科,上海200040 [3]上海市儿童医院,上海交通大学附属儿童医院病理科,上海200040 [4]北京大学人民医院,北京大学血液病研究所,北京100044

出　　处：《中国小儿血液与肿瘤杂志》2021年第2期105-109,共5页Journal of China Pediatric Blood and Cancer

基　　金：上海市卫生健康委员会科研课题基金(20194Y0112);上海申康医院发展中心重大临床研究项目(SHDC2020CR4089)。

摘　　要：目的探讨儿童造血干细胞移植后供者来源CAR-T细胞治疗的临床疗效和不良反应。方法报道2例供者来源CAR-T细胞治疗后继发慢性移植物抗宿主病(cGVHD),并复习相关文献。结果回输供者来源CAR-T细胞后均经历了不同程度的cGVHD,以闭塞性细支气管炎(BO)最为严重。早期积极干预后呼吸困难和肺功能得到了明显改善和恢复。CAR-T后随访超过24个月,均为白血病持续完全缓解状态,没有接受二次移植。结论异基因造血干细胞移植后供者来源的CAR-T细胞治疗可能诱发严重cGVHD,及时有效干预对改善预后及提高生存质量至关重要。Objective To investigate the clinical efficacy and adverse reactions of donor derived chimeric antigens receptor-T(CAR-T)cell therapy after hematopoietic stem cell transplantation(HSCT)in children.Methods Two cases of chronic graft-versus-host disease(cGVHD)secondary to donor derived CAR-T cell therapy were reported,and related literatures were reviewed.Results After transfusion of donor derived CAR-T cells,the children experienced different degrees of cGVHD,especially bronchiolitis obliterans(BO).Their dyspnea and lung function were significantly improved and recovered after early intervention.The patients were followed up for more than 24 months after CAR-T,and leukemia were in complete remission without secondary transplantation.Conclusions After allo-HSCT,donor-derived CAR-T cell therapy may induce severe cGVHD.Timely and effective intervention is crucial to improve both prognosis and quality of life.

关 键 词：供者来源 嵌合抗原受体T细胞 慢性移植物抗宿主病 

分 类 号：R457.7[医药卫生—治疗学]