ABSTRACT
Objective@#To validate the prognostic value of chronic lymphocytic leukemia-international prognostic index (CLL-IPI) for Chinese CLL patients.@*Methods@#Two hundred and fifteen CLL patients who were initially diagnosed and treated in Jiangsu Province Hospital from January 2002 to November 2017 were included in the retrospective analysis. Risk stratification and prognosis were evaluated by CLL-IPI scoring system.@*Results@#①Of the 215 patients, 143 were males and 72 were females, with a median age of 60 (16-85) years old. The median treatment-free survival (TFS) and overall survival (OS) was 16 months (4-24 months) and 180 months (145-215 months), respectively. ② The median TFS for low (n=60), intermediate (n=50), high (n=45) and very high risk group (n=60) according to the CLL-IPI scoring system was 56, 15, 12 and 5 months, respectively (P<0.001). ③ The median follow-up was 48 months (1-192 months). The median OS for low risk group was not reached and for intermediate, high, and very high risk group was 180, 89 and 74 months, respectively. The estimated 5-year OS rate was 97.6%, 83.7%, 67.8% and 55.2%, respectively (P<0.001). ④ Multivariate analysis indicated that unmutated immunoglobulin heavy chain variable region (IGHV) gene and β2-microglobulin>3.5 mg/L(P<0.001) were independent prognostic factors of TFS, while TP53 deletion and/or mutation(P=0.008), unmutated IGHV (P=0.017) and age>65 years(P=0.045) were independent prognostic factors of OS.@*Conclusion@#CLL-IPI is the powerful tool for risk stratification in Chinese CLL patients.
ABSTRACT
As a novel immune therapy for cancer, chimeric antigen receptor T-cell (CAR-T) immunotherapy has attracted more and more attention. Toxicities of CAR-T therapy include cytokine release syndrome (CRS), neurologic toxicities and on-target, off-tumor toxicity. CRS, which is the most severe adverse event of CAR-T immunotherapy, affects many organs, such as cardiovascular, nervous, digestive, hematological systems, and so on. Besides symptomatic treatment, tocilizumab (anti-interleukin monoclonal 6 antibody), etanercept (anti-tumor necrosis factor monoclonal antibody) and glucocorticoid are the core treatments to control CRS. Better understanding of CRS promotes the application of CAR-T immunotherapy.
ABSTRACT
Chimeric antigen receptor-T cell (CAR-T) therapy is one of the effective novel immunotherapy for malignancies, and it has a great effect on leukemia and lymphoma. More researches are needed to improve the understanding of CAR-T therapy and promote the development of this technology in order to treat hematological malignancies from a novel perspective.