嵌合抗原受体T细胞免疫疗法治疗伯基特淋巴瘤的有效性及安全性研究

Efficacy and Safety of Chimeric Antigen Receptor T Cell Immunotherapy in the Treatment of Burkitt's Lymphoma

目的探讨嵌合抗原受体T细胞(CART)疗法治疗成人伯基特淋巴瘤(Burkitt's lymphoma,BL)的有效性及安全性。方法评估2017年7月—2021年11月接受CART治疗的9例BL患者的近期、远期随访疗效及不良反应。结果9例患者输注CART细胞30 d后,总有效率为66.67%。其中CR率为44.44%,PR率为22.22%,输注CART后,共7例患者发生不同程度的细胞因子释放综合征(CRS),其中3例为1~2级CRS,4例发生3级CRS反应,及时应用妥珠单抗和/或小剂量激素后,CRS均得到有效控制。所有患者均未发生免疫效应细胞相关神经毒性综合征(ICANS)。结论CART疗法对成人BL患者有一定疗效,可作为复发难治患者的挽救治疗选择之一,且安全可控。及时地监测及管理有助于防止不良结局的发生。但也存在疗效短、易复发的缺点,仍需要探索安全有效的后续桥接治疗。

Objective To explore the efficacy and safety of chimeric antigen receptor T cell(CART)therapy in the treatment of adult Burkitt's lymphoma(BL)patients.Methods 9 BL patients received CART treatment from July 2017 to November 2021.The short-term and long-term follow-up efficacy and adverse reactions were evaluated after CART.Results After 30 days of CART infusion,the total effective rate was 66.67%,while the CR rate of 9 patients was 44.44%and PR rate was 22.22%.7 patients developed varying degrees of cytokine release syndrome(CRS)after CART infusion,including 3 cases of grade 1-2 CRS and 4 cases of grade 3 CRS response.After timely application of Tuzumab and/or small-dose of Dexamethasone,CRS was effectively controlled.None patients experienced immune effector cell-associated neurotoxicity syndrome(ICANS).Conclusion CART therapy has a certain therapeutic effect on adult BL patients and can be one of the salvage treatment options for relapsed and refractory BL patients,with controllable adverse reactions.Timely monitoring and management of adverse reactions after infusion can help prevent the occurrence of uncontrollable outcomes.However,there are also shortcomings such as short-time efficacy and high risk of recurrence.It is still necessary to explore safe and effective follow-up bridging treatments.