分享人（IL-6）ELISA試劑盒引用的文獻

文獻題目 ：CAR?T 19 combined with reduced?dose PD?1 blockade therapy

作者單位：天津第一中央醫院血液科

引用試劑盒：

【RJ11850】人白細胞介素6（IL-6）ELISA試劑盒

Anti?CD19 chimeric antigen receptor T cell (CAR?T) therapy has changed the typical outcomes of relapsed/refractory B?cell leukemia and lymphoma. However, treatment effectiveness for patients with relapsed/refractory B?cell non?Hodgkin lymphoma has been less satisfactory compared with patients with B?cell acute lymphoblastic leukemia. The present study described a case of refractory follicular lymphoma. A high expression of programmed cell death 1 (PD?1) was measured on CD3+ T cells (80.90%) in peripheral blood samples obtained from the patient enrolled in this study, indicating that treatment with autologous CAR?T 19 cell therapy may not be successful. Therefore, a therapy regimen consisting of CAR?T 19 cells in combination with a reduced dose of nivolumab (1.5 mg/kg) for PD?1 blockade was used. A low dose of PD?1 blockade therapy was used to reduce the adverse effects associated with the combination of a PD?1 inhibitor and CAR?T 19 cells. This salvage therapy resulted in remission that lasted for >10 months.

Introduction

Although refined chemotherapy, including rituximab (an anti-CD20 monoclonal antibody), and autologous stem cell transplantation have improved the prognosis for B-cell non-Hodgkin lymphoma (B-NHL), patients with refractory B-NHL still have a poor prognosis (1,2). Approximately 19–26% of patients with follicular lymphoma (FL) receiving first-line immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) experienced progression of disease within 24 months (2). Chimeric antigen receptor (CAR) T cells are a remedial treatment for these patients. Anti-CD19 CAR T cell (CAR-T 19) therapies have exhibited potent activity against numerous subtypes of B-NHL, including FL (3). Nivolumab, the human immunoglobulin G4 programmed death-1 (PD-1) immune checkpoint inhibitor antibody with high affinity to PD-1 receptors on T cells, could block their interaction with PD ligands 1 and 2 (PD-L1/PD-L2) and restore T-cell function (4). A significant association between the expression levels of PD-1 on T cells and the immunosuppression of T cells has previously been reported (5). A study that focused on the use of Nivolumab in a cohort of 10 patients with relapsed or refractory FL, reported the overall response rate was four patients (40%), and one achieved complete response (6). Meanwhile, PD-1 inhibitors may lead to an imbalance in immune tolerance and uncontrolled immune response, even fatal myocarditis (7). The present study describes a patient with successfully treated refractory FL, who received anti-CD19 CAR-T cells combined with decreased dose PD-1 inhibitor regimen.