Coagulation function changes after CD19-CAR-T cells immunotherapy for B-ALL and its related factors
10.3760/cma.j.cn114452-20220617-00354
- VernacularTitle:CD19-嵌合抗原受体-T细胞免疫治疗对B-ALL患者凝血功能的影响及相关因素研究
- Author:
Lan DAI
1
;
Linyan HE
;
Ziling ZHU
;
Shengli XUE
;
Mengjie CAI
;
Haixia ZHOU
;
Zhaoyue WANG
;
Mingqing ZHU
Author Information
1. 苏州大学附属第一医院 江苏省血液研究所，国家血液系统疾病临床医学研究中心 苏州 215006
- Keywords:
Acute lymphoblastic leukemia;
Cell treatment;
Coagulation function;
Cytokine
- From:
Chinese Journal of Laboratory Medicine
2022;45(8):846-851
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes of various cytokines and coagulation function in B cell acute lymphoblastic leukemia(ALL) patients with different CRS scores during CD19-CAR-T cell immunotherapy.Methods:87 patients with B-ALL hospitalized in the First Affiliated Hospital of Soochow University and 30 normal controls were enrolled into this study from July 2018 to October 2020. The age of the patients was 32(20, 56) years old and 36(41.4%) were female. All these coagulation indicators, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, fibrinogen (Fg) were analyzed by automatic blood coagulation in B-ALL patients before and after treated with CAR-T cell. The ratio of CD19-CAR-T cells and the expression of IL-6, IL-10, IFN-γ, TFN-α, IL-2, IL-4, and IL-17A were analyzed using flow cytometry. The patients′ clinical parameters were detected, and the CRS classification of severity was made according to the standard of consensus.Results:Patients with CRS>3 had prolonged PT and APTT, increased D-dimer, and decreased fibrinogen ( P<0.05). The levels of cytokines of IFN-γ, IL-6, and IL-10 were significantly higher in patients with CRS>3 than that in controls ( P<0.05).The D-dimer level is positively correlated with IL-10. Conclusion:Patients with severe CRS grading have significant coagulation dysfunction in CD19-CAR-T cell immunotherapy. Cytokines IFN-γ, IL-6, and IL-10 may affect coagulation function and CRS grading during CD19-CAR-T cell immunotherapy.
