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Mismatched donor cell infusion-related syndrome following microtransplant in patients with acute myeloid leukemia

Chinese Medical Journal 2023年第7期136卷 815-821页

作者： Bo Cai Xiaoyan Zou Xin Ning Tieqiang Liu Bingxia Li Yaqing Lei Jianhui Qiao Kaixun Hu Yangyang Lei Zhiqing Liu Bo Yao Huisheng Ai Yi Wang Changlin Yu Mei Guo Department of Hematology The Fifth Medical CenterChinese PLA General HospitalBeijing 100071China

Background:Immunotherapies such as adoptive immune cell infusion and immune-modulating agents are widely used for cancer treatment,and the concomitant symptoms,including cytokine release syndrome(CRS)or immune-related adverse events(irAEs),are frequently ***,clinical manifestations induced by mismatched donor granulocyte colony-stimulating factor mobilized peripheral blood mononuclear cell(GPBMC)infusion in patients receiving microtransplant(MST)have not yet been well ***:We analyzed 88 cycles of mismatched GPBMC infusion in patients with acute myeloid leukemia receiving MST and 54 cycles of chemotherapy without GPBMC infusion as a *** symptoms and their correlation with clinical features,laboratory findings,and clinical response were ***:Fever(58.0%[51/88])and chills(43.2%[38/88])were the significant early-onset symptoms after GPBMC *** possessing less human leukocyte antigen-matching loci with the donor or those with unrelated donors experienced more chills(3[2–5]loci vs.5[3–5]loci,P=0.043 and 66.7%[12/18]vs.37.1%[26/70],P=0.024).On the other hand,those with decreased CD4^(+)/CD8^(+)T-cell ratio developed more fever(0.8[0.7–1.2]vs.1.4[1.1–2.2],P=0.007).Multivariable analysis demonstrated that younger patients experienced more fever(odds ratio[OR]=0.963,95%confidence interval[CI]:0.932–0.995,P=0.022),while patients with younger donors experienced more chills(OR=0.915,95%CI:0.859–0.975,P=0.006).Elevated ultra-sensitive C-reactive protein levels in the absence of cytokine storm were observed following GPBMC infusion,which indicated mild and transient inflammatory *** no predictive value of infusion-related syndrome to leukemia burden change was found,the proportion of host pre-treatment activated T cells was positively correlated with leukemia ***:Mismatched GPBMC infusion in MST induced unique infusion-related symptoms and laboratory changes,which were associated with

关键词： microtransplant Immunotherapy Adoptive immune cell infusion Adverse events Acute myeloid leukemia

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