复发/难治急性B淋巴细胞白血病行CAR-T细胞治疗后接受粒细胞集落刺激因子的疗效及安全性分析  

Efficacy and safety analysis of granulocyte colony-stimulating factor after chimeric antigen receptor-modified T cell therapy for relapsed/refractory B cell acute lymphoblastic leukemia

作　　者：曹芯萍 张萌[1] 张笑梅 赵明峰[1,2,3] CAO Xinping;ZHANG Meng;ZHANG Xiaomei;ZHAO Mingfeng(The First Center Clinic College of Tianjin Medical University,Tianjin 300392,China;Nankai University School of Medicine,Tianjin 300110,China;Department of Hematology,Tianjin First Central Hospital,Tianjin 300392,China)

机构地区：[1]天津医科大学第一中心临床学院,天津300392 [2]南开大学医学院,天津300110 [3]天津市第一中心医院血液科,天津300392

出　　处：《中国免疫学杂志》2024年第12期2604-2608,共5页Chinese Journal of Immunology

基　　金：国家自然科学基金(81970180);天津市医学重点学科(专科)建设项目(TJYXZDXK-056B);天津市自然科学基金(22JCQNJC00820);天津市卫生健康科技项目(TJWJ2022XK018,TJWJ2022QN030)。

摘　　要：目的:回顾性分析接受CAR-T细胞治疗后发生中性粒细胞减少症(NE)的复发/难治急性B淋巴细胞白血病(R/R B-ALL)患者应用粒细胞集落刺激因子(G-CSF)的疗效和安全性。方法:纳入2017年3月至2022年12月于天津市第一中心医院接受CAR-T细胞治疗的R/R B-ALL患者99例,这些患者均发生NE并随后接受G-CSF治疗,按照G-CSF使用时间分为早期G-CSF组(7 d内使用,n=56)与对照组(7 d后使用,n=43),分析G-CSF应用后NE恢复情况及不良反应发生情况。结果:早期G-CSF组患者NE持续时间短于对照组[4(2,5.7)vs 11(9,14),P<0.05],但两组中性粒细胞计数(ANC)最低值、NE分级及感染发生率差异均无统计学意义(P=0.261,P=0.090,P=0.111)。两组患者细胞因子释放综合征(CRS)发生率及严重程度无明显差异,所有患者CRS均能有效控制。结论:R/R B-ALL患者进行CAR-T细胞治疗后早期运用G-CSF能缩短NE恢复时间,且对CAR-T细胞治疗后不良反应发生无明显影响。Objective:To retrospectively analyze efficacy and safety of granulocyte colony-stimulating factor(G-CSF)in relapsed/refractory B cell acute lymphoblastic leukemia(R/R B-ALL)patients with neutropenia(NE)after receiving CAR-T cell therapy.Methods:From March 2017 to December 2022,99 patients with R/R B-ALL developed NE after receiving CAR-T cell therapy in Tianjin First Central Hospital were collected and divided into two groups according to using time of G-CSF.One was early G-CSF group(received G-CSF within 7 days,n=56),the other was control group(received G-CSF after 7 d,n=43),whose recovery of NE and occurrence of adverse reactions after G-CSF were compared.Results:Duration of NE in early G-CSF group was shorter than control group[4(2,5.7)vs 11(9,14),P<0.05],but there were no significant differences in the lowest absolute neutrophil count(ANC),degree of NE inhibition and incidence of infection(P=0.261,P=0.09,P=0.111).There was no significant difference between incidence and severity of cytokine release syndrome(CRS)between two groups,and CRS was controllable in all patients.Conclusion:Early application of G-CSF in R/R B-ALL patients after CAR-T cell therapy can shorten duration of NE,and has no significant effect on adverse reactions after CAR-T cells.

关 键 词：急性B淋巴细胞白血病 嵌合抗原受体修饰T细胞 粒细胞集落刺激因子 

分 类 号：R457.2[医药卫生—治疗学]