Inflammatory signatures for quick diagnosis of life-threatening infection during the CAR T-cell therapy
| العنوان: | Inflammatory signatures for quick diagnosis of life-threatening infection during the CAR T-cell therapy |
|---|---|
| المؤلفون: | Qian Zhang, Yi Xiao, Xia Mao, Chunrei Li, Liang Huang, Lijun Jiang, Songya Liu, Di Wang, Na Wang, Jinhuan Xu, Jin Jin, Xiaoxi Zhou, Jianfeng Zhou, Jue Wang, Yang Cao, Liting Chen, Bin Xu, Hui Luo, Min Xiao |
| المصدر: | Journal for Immunotherapy of Cancer Journal for ImmunoTherapy of Cancer, Vol 7, Iss 1, Pp 1-11 (2019) |
| بيانات النشر: | BioMed Central, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 0301 basic medicine, Male, Cancer Research, medicine.medical_treatment, Immunotherapy, Adoptive, Severity of Illness Index, 0302 clinical medicine, Immunology and Allergy, Interleukin, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prognosis, Cytokine release syndrome, Oncology, 030220 oncology & carcinogenesis, Molecular Medicine, Cytokines, Female, Inflammation Mediators, Infection, Algorithms, Research Article, Adult, medicine.medical_specialty, Chimeric antigen receptor-modified T-cell therapy, Adolescent, Immunology, Malignancy, Infections, lcsh:RC254-282, Sepsis, 03 medical and health sciences, Young Adult, Antigen, Internal medicine, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma, medicine, Humans, Adverse effect, Aged, Pharmacology, business.industry, Immunotherapy, medicine.disease, Clinical trial, 030104 developmental biology, Early Diagnosis, Inflammatory factors, business, Biomarkers |
| الوصف: | Background Chimeric antigen receptor-modified (CAR) T-cell immunotherapy is a novel promising therapy for treatment of B-cell malignancy. Cytokine release syndrome (CRS) and infection are the most common adverse events during CAR T-cell therapy. Similar clinical presentation of concurrent CRS and infection makes it difficult to differentially diagnose and timely treat the condition. Methods We analyzed the features of infection events during the first 30 days after CAR T-cell infusion (CTI) in 109 patients from three clinical trials (ChiCTR-OPN-16008526, ChiCTR-OPC-16009113, ChiCTR-OPN-16009847). Based on the dynamic changes of interleukin (IL)-6 and ferritin, we proposed the “double peaks of IL-6” pattern as a feature of life-threatening infection during the first 30 days after CTI. Meanwhile, we screened candidate biomarkers from 70-biomarker panel to establish a prediction model for life-threatening infection. Results In this study, 19 patients (17.4%) experienced a total of 19 infection events during the first 30 days after CAR T-cell infusion. Eleven patients (10.1%) had grade 4–5 infection, which were all bacterial infection and predominantly sepsis (N = 9). “Double peaks of IL-6” appeared in 9 out of 11 patients with life-threatening infection. The prediction model of three-cytokines (IL-8, IL-1β and interferon-γ) could predict life-threatening infection with high sensitivity (training: 100.0%; validation: 100.0%) and specificity (training: 97.6%; validation: 82.8%). On base of the aforementioned methods, we proposed a workflow for quick identification of life-threatening infection during CAR T-cell therapy. Conclusions In this study, we worked out two diagnostic methods for life-threatening infection during CAR T-cell therapy by analyzing inflammatory signatures, which contributed to reducing risks of infection-induced death. |
| اللغة: | English |
| تدمد: | 2051-1426 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b7b41ddb1424cc536814fff963bf3f82Test http://europepmc.org/articles/PMC6806557Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b7b41ddb1424cc536814fff963bf3f82 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20511426 |
|---|