医学
凝血病
细胞因子释放综合征
内科学
凝结
耐火材料(行星科学)
胃肠病学
免疫学
细胞因子
嵌合抗原受体
入射(几何)
凝血障碍
多发性骨髓瘤
免疫疗法
肿瘤科
癌症
物理
光学
天体生物学
作者
Mi Shao,Qinghua Yu,Xinyi Teng,Xin Guo,Guoqing Wei,Huijun Xu,Jiazhen Cui,Alex H. Chang,Yongxian Hu,He Huang
标识
DOI:10.1038/s41409-021-01226-9
摘要
Chimeric antigen receptor (CAR) T-cell therapy that targets B-cell maturation antigen (BCMA) has shown promising effects in the treatment of patients with refractory/relapsed multiple myeloma (R/R MM) patients. In this retrospective analysis of phase I/II clinical trial (ChiCTR1800017404), 37 patients with R/R MM received their first BCMA-targeted CAR T-cells following lymphodepletion chemotherapy. The response rate was high (97%), while accompanied by a high incidence of adverse events including coagulation dysfunction. Of 37 patients, all (100%) had cytokine release syndrome (CRS) and 34 (91%) developed at least one abnormal coagulation parameter. The values of coagulation parameters were positively correlated with the severity of CRS as well as with the levels of some cytokines, such as interleukin (IL)-6, IL-10, and interferon (IFN)-γ, etc. Furthermore, levels of the plasma tissue factor (TF), Factor X (FX), Factor XII (FXII), and P-selectin also showed a positive correlation with severity of CRS as well as some specific cytokines, which indicates that these factors are likely to play important roles in CRS-related coagulopathy. Our study suggests that there exists relationship in some extent between coagulation disorder and CRS. Moreover, coagulation dysfunction can be managed with daily monitoring and early intervention despite high incidence.
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