儿童CAR-T细胞治疗中细胞因子释放综合征的研究进展  

Progress of cytokine release syndrome in children CAR-T cell therapy

作　　者：杨静[1] 李本尚[1] Yang Jing;Li Benshang(Department of Hematology and Oncology,Shanghai Children′s Medical Center,Shanghai JiaoTong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心血液肿瘤科,200127

出　　处：《国际儿科学杂志》2022年第12期793-798,共6页International Journal of Pediatrics

基　　金：上海市转化医学协同创新中心基金资助(TM201928)。

摘　　要：作为一种颠覆性的治疗技术,嵌合抗原受体T细胞(chimeric antigen receptor T-cell,CAR-T)免疫疗法在治疗复发、难治的儿童急性淋巴细胞白血病中取得了突破性进展,其原理是通过基因工程技术在T细胞表面表达外源性的嵌合抗原受体蛋白,靶向肿瘤特异性抗原,针对肿瘤细胞发挥特异性的细胞毒作用而杀伤肿瘤细胞。与此同时,CAR-T免疫治疗也会产生严重的不良反应,其中最需关注的是细胞因子释放综合征(cytokine release syndrome,CRS),CRS处理不当可能发生严重并发症甚至死亡。该文主要从CRS发生的机制、临床表现、分级与临床处理等方面阐述儿童急性淋巴细胞白血病CAR-T免疫治疗中CRS的研究进展。As a disruptive therapeutic technique,chimeric antigen receptor T-cell(CAR-T)immunotherapy has achieved a revolutionary breakthrough in pediatric patients with relapsed/refractory acute lymphoblastic leukemia(ALL).Using genetic engineering technology,T lymphocytes can be modified to express CAR on the surface,which then target tumor-specific antigens and exert cytotoxic effects against tumor cells.However,CAR-T therapy may cause some serious adverse reactions,of which the most common and noticeable is cytokine release syndrome(CRS).Inappropriate medical management of CRS will lead to severe complications and can be even life-threating.In this review,we mainly discuss the progress of CRS in the CAR-T therapy of children ALL from the aspects of the mechanism,clinical manifestations,grading systems and clinical treatment.

关 键 词：儿童 急性淋巴细胞白血病 嵌合抗原受体T细胞 细胞因子释放综合征 

分 类 号：R733.71[医药卫生—肿瘤]