抗BCMA CAR-T细胞治疗复发难治性AQP4-IgG血清阳性视神经脊髓炎谱系疾病的术后管理  

Postoperative Management of Recurrent and Refractory AQP4-IgG Seropositive Neuromyelitis Optica Spectrum Disorder(NMOSD)Treated with Anti-BCMA CAR-T Cell Therapy

作　　者：陈黛琪 许艳梅 肖萍 李芳芳 CHEN Daiqi;XU Yanmei;XIAO Ping;LI Fangfang(Department of Neurology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030

出　　处：《神经损伤与功能重建》2024年第11期639-643,共5页Neural Injury and Functional Reconstruction

摘　　要：目的:总结11例复发难治性AQP4-IgG血清阳性视神经脊髓炎谱系疾病患者行抗BCMA CAR-T细胞治疗后神经系统症状的管理经验。方法:对11例抗BCMA CAR-T细胞治疗回输后患者行一般护理观察、细胞因子释放综合征、神经系统症状管理、心理护理、适时康复管理。结果:在中位随访5.5个月(范围1~14个月)期间,11例患者停用所有皮质类固醇和免疫抑制剂后实现无药物缓解均无复发;11例患者报告扩展残疾评定和生活质量的改善。结论:回输后密切观察、早期发现神经系统症状并给予有效管理,减轻患者痛苦,确保抗BCMA CAR-T细胞疗法治疗复发难治性AQP4-IgG血清阳性视神经脊髓炎谱系疾病临床顺利实施。Objective:To summarize the management experience of neurological symptoms in 11 patients with recurrent and refractory AQP4-IgG seropositive neuromyelitis optica spectrum disorder(NMOSD)treated with anti-BCMA CAR-T cell therapy.Methods:General nursing observation,management of cytokine release syndrome(CRS),neurological symptoms,psychological care,and timely rehabilitation management were implemented for 11 patients after infusion of anti-BCMA CAR-T cells.Results:During a median follow-up period of 5.5 months(range:1~14 months),all 11 patients achieved drug-free remission without relapse after discontinuing all corticosteroids and immunosuppressants.Additionally,all 11 patients reported improvements in the Expanded Disability Status Scale(EDSS)and quality of life.Conclusion:Close observation and early detection of neurological symptoms after infusion,coupled with effective management,can alleviate patient suffering and ensure the successful clinical implementation of anti-BCMA CAR-T cell therapy for recurrent and refractory AQP4-IgG seropositive neuromyelitis optica spectrum disorder.

关 键 词：抗BCMA CAR-T细胞疗法 复发难治性AQP4-IgG血清阳性视神经脊髓炎谱系疾病 神经系统症状 护理管理策略 

分 类 号：R741[医药卫生—神经病学与精神病学] R744.52[医药卫生—临床医学]