Background Im paired sesitwity of he soin Mlush response bo miacin is one of the most rpicated findngs in patents with schizoprenia Howewer.prior studies have usaly focused on postonset psychusis,and ll is knowm about...Background Im paired sesitwity of he soin Mlush response bo miacin is one of the most rpicated findngs in patents with schizoprenia Howewer.prior studies have usaly focused on postonset psychusis,and ll is knowm about the dinical high-risk(CHR)phase of niacin senstity in psychosis Aims To proftle and compare the miacin flush responsge among CHR individuals(converters and non-coverters)patients with frstepso schinophrenia(FES)and healty controls(HCs).Methods Sensivily 1o ftour concentralions (0.1-0001M)of aqueous methylnicotinate was tested in 105 CHR individuals,57 patients with FES and 52 HCs.CHR individuals were further grouped as converters and non converters according to the 2-year follow-up outcomes.Skin flush response scores were rated on a 4-point scale.Results Of the 105 CHR individuals,21 individuals were lost during the study,leaving 84 CHR individuals;16(19.0%)converted to full psychosis at 2 years of fllow-up.Flush response scores identifed in the CHR samples were characterised as modest degree levels,intermediate between those of HC individuals and patients with FES.The flush responses in the CHR group mimicked the responses observed in the FES group at higher concentrations(0.01 M,0.1 M)and longer time points(15 min,20min);however,these became comparable vith the responses in the HC group at the shorter time points and at lower concentr ations.The converters exhibited lower mean flush response scores than the non-converters.Conclusions Attenuated niacin-induced flushing emerged during the early phase of psychosis.New devices should be developed and verified for objective quantification of skin responses in the CHR population.展开更多
Background Disrupted white matter(WM)microstructure has been commonly identified in youth at clinical high risk(CHR)for psychosis.Several lines of evidence suggest that fatty acids,especially unsaturated fatty acids(U...Background Disrupted white matter(WM)microstructure has been commonly identified in youth at clinical high risk(CHR)for psychosis.Several lines of evidence suggest that fatty acids,especially unsaturated fatty acids(UFAs),might play a crucial role in the WM pathology of early onset psychosis.However,evidence linking UFA and WM microstructure in CHR is quite sparse.Aims We investigated the relationship between the plasma UFA level and WM microstructure in CHR participants and healthy controls(HC).Methods Plasma fatty acids were assessed and diffusion tensor imaging(DTI)data were performed with tract-based spatial statistics(TBSS)analysis for 66 individuals at CHR for psychosis and 70 HC.Results Both the global and regional diffusion measures showed significant between-group differences,with decreased fractional anisotropy(FA)but increased mean diffusivity(MD)and radial diffusivity(RD)found in the CHR group compared with the HC group.On top of that,we found that in the HC group,plasma arachidic acid showed obvious trend-level associations with higher global FA,lower global MD and lower global RD,which regionally spread over the corpus callosum,right anterior and superior corona radiata,bilateral anterior and posterior limb of the internal capsule,and bilateral superior longitudinal fasciculus.However,there were no associations between global WM measures and any UFA in the CHR group.Conversely,we even found negative associations between arachidic acid levels and regional FA values in the right superior longitudinal fasciculus and right retrolenticular part of the internal capsule in the CHR group.Conclusions Compared with the HC group,CHR subjects exhibited a different pattern of association between WM microstructure and plasma UFA,with a neuroprotective effect found in the HC group but not in the CHR group.Such discrepancy could be due to the excessively upregulated UFAs accumulated in the plasma of the CHR group,highlighting the role of balanced plasma-membrane fatty acids homeostasis in WM development.展开更多
Background Neural oscillations directly reflect the rhythmic changes of brain activities during the resting state or while performing specific tasks.Abnormal neural oscillations have been discovered in patients with s...Background Neural oscillations directly reflect the rhythmic changes of brain activities during the resting state or while performing specific tasks.Abnormal neural oscillations have been discovered in patients with schizophrenia.However,there is limited evidence available on abnormal spontaneous neural oscillations in clinical high risk for psychosis(CHR-P).The brain signals recorded by the magnetoencephalography(MEG)technique are not to be disrupted by the skull and scalp.Methods In this study,we applied the MEG technique to record the resting-state neural activities in CHR-P.This was followed by a detailed MEG analysis method including three steps:(1)preprocessing,which was band-pass filtering based on the 0.5-60Hz frequency range,removal of 50Hz power frequency interference,and removal of electrocardiography(ECG)and electrooculography(EOG)artefacts by independent component analysis;(2)time-frequency analysis,a multitaper time-frequency transformation based on the Hanning window,and(3)source localisation.an exact low-resolution brain electromagnetic tomography.The method was verified by comparing aparticipant with CHR-P with a healthy control during the MEG recordings with an eyes-closed resting state.Results Experimental results show that the neural oscillations in CHR-P were significantly abnormal in the theta frequency band(4-7Hz)and the delta frequency band(1-3Hz).Also,relevant brain regions were located in the left occipital lobe and left temporo-occipital junction for the theta band and in the right dorsolateral prefrontal lobe and near orbitofrontal gyrus for the delta band.Conclusions Abnormal neural oscillations based on specific frequency bands and corresponding brain sources may become biomarkers for high-risk groups.Further work will validate these characteristics in CHR-P cohorts.展开更多
Background Clinical high risk(CHR)of psychosis is a state in which positive symptoms cause the subjects distress but do not approach a severity level that fulfils the criteria for a psychotic episode.CHR exhibits cogn...Background Clinical high risk(CHR)of psychosis is a state in which positive symptoms cause the subjects distress but do not approach a severity level that fulfils the criteria for a psychotic episode.CHR exhibits cognitive deficits;however,the underlying neurobiological mechanisms remain unclear.This study aimed to investigate whether brain activation measured by the levels of oxygenated hemoglobin(oxy-Hb)in CHR subjects could be correlated with cognitive deficits.Methods Fifty-eight CHR individuals who fulfilled the criteria for attenuated positive syndrome as specified in the Structured Interview for Prodromal Syndrome(SIPS)and the Scale of Prodromal Syndrome(SOPS)and 58 age-and sex-matched healthy participants were included in the study.All subjects completed the Measurement and Treatment Research to Improve Cognition in Schizophrenia(MATRICS)Consensus Cognitive Battery(MCCB)that includes tests measuring attention,verbal memory,verbal fluency,executive function,and general intelligence.Functional near-infrared spectroscopy(fNIRS)was used to measure the level of oxy-Hb in the dorsolateral prefrontal and frontotemporal cortices.Results We observed significantly decreased oxy-Hb levels in channel 32(located in the right superior temporal gyrus,rSTG)within the CHR individuals compared with that in the healthy controls(HCs)(t=−3.44,Bonferroni-corrected p=0.002),indicating lower brain activity.A significant positive correlation was observed between task-relatedβvalues and working memory in the CHR group(r=0.35,p=0.008).Conclusions The brain activation of rSTG is abnormal among subjects at clinicial high risk for psychosis.This abnormality is probably associated with the neural mechanisms of deficits in the working memory during the early stage of psychosis.展开更多
Background Self-reflectiveness,one dimension of cognitive insight,plays a protective role in an individual’s mental state.Both high and low levels of self-reflectiveness have been reported in patients with schizophre...Background Self-reflectiveness,one dimension of cognitive insight,plays a protective role in an individual’s mental state.Both high and low levels of self-reflectiveness have been reported in patients with schizophrenia and individuals at clinical high risk for the illness.Aims This study aimed to explore the relationship patterns between self-reflectiveness and clinical symptoms in individuals during the pre-morbid and early clinical stages of psychosis.Methods A total of 181 subjects,including individuals with attenuated positive symptoms(APS,n=122)and patients with first-episode psychosis(FEP,n=59),completed the Beck Cognitive Insight Scale and were evaluated using the Schedule of Assessment of Insight and Positive and Negative Syndrome Scale.All subjects were classified into three groups according to their level of selfreflectiveness:low level(LSR,n=59),medium level(MSR,n=67)and high level(HSR,n=55).Both linear and nonlinear relationships between self-reflectiveness and clinical symptoms were explored.Results More individuals with APS were classified into the MSR group,while more patients with FEP were classified into the LSR group.The LSR group demonstrated less awareness of illness than the MSR and HSR groups,more stereotyped thinking and poorer impulse control but less anxiety than the MSR group,and lower levels of blunted affect and guilt feelings than the HSR group.The MSR group demonstrated lower stereotyped thinking than the HSR group.Compared to the LSR group,the MSR group had increased selfreflectiveness,improved awareness of illness,decreased stereotyped thinking,and better impulse control,but increased feelings of guilt.The HSR group showed increased stereotyped thinking when compared to the MSR group,but the other variables did not change significantly between these two groups.Overall,self-reflectiveness demonstrated an approximately inverse S-shaped relationship with the awareness of illness,a U-shaped relationship with stereotyped thinking and poor impulse control,and an almost linear relationship with anxiety and guilt feelings.Conclusions Self-reflectiveness demonstrates complex relationships with clinical symptoms and fails to exert significant positive effects when reaching a certain high level.展开更多
Factors associated with complete and durable remissions after anti-CD19 chimeric antigen receptor T(CAR-T)cell immunotherapy for relapsed or refractory non-Hodgkin lymphoma(r/r NHL)have not been well characterized.In ...Factors associated with complete and durable remissions after anti-CD19 chimeric antigen receptor T(CAR-T)cell immunotherapy for relapsed or refractory non-Hodgkin lymphoma(r/r NHL)have not been well characterized.In this study,we found that the different sites of extranodal involvement may affect response,overall survival(OS),and progression-free survival(PFS)in patients with r/r NHL treated with anti-CD19 CAR-T cells.In a cohort of 32 treated patients,12(37.5%)and 8(25%)patients exhibited soft tissue lymphoma and bone marrow(BM)infiltrations,respectively,and 13(41%)patients exhibited infiltration at other sites.The factors that may affect prognosis were identified through multivariable analysis.As an independent risk factor,soft tissue infiltration was the only factor significantly correlated with adverse prognosis(P<0.05),whereas other factors did not reach statistical significance.Furthermore,the site of extranodal tumor infiltration significantly and negatively affected OS and PFS in patients with r/r NHL treated with anti-CD19 CAR-T cell therapy.PFS and OS in patients with BM involvement were not significantly different from those of patients with lymph node involvement alone.Thus,anti-CD19 CAR-T cell therapy may improve the prognosis of patients with BM infiltration.展开更多
Mantle cell lymphoma(MCL)is a distinct histological type of B-cell lymphoma with a poor prognosis.Several agents,such as proteasome inhibitors,immunomodulatory drugs,and inhibitors of B cell lymphoma-2 and Bruton’s t...Mantle cell lymphoma(MCL)is a distinct histological type of B-cell lymphoma with a poor prognosis.Several agents,such as proteasome inhibitors,immunomodulatory drugs,and inhibitors of B cell lymphoma-2 and Bruton’s tyrosine kinase have shown efficacy for relapsed or refractory(r/r)MCL but often have short-term responses.Chimeric antigen receptor(CAR)T-cell therapy has emerged as a novel treatment modality for r/r non-Hodgkin’s lymphoma.However,long-term safety and tolerability associated with CAR T-cell therapy are not defined well,especially in MCL.In this report,we described a 70-year-old patient with r/r MCL with 48-month duration of follow-up who achieved long-term remission after CAR T-cell therapy.CAR T-cell-related toxicities were also mild and tolerated well even in this elderly patient.This report suggested that CAR T-cell therapy is a promising treatment modality for patients with MCL,who are generally elderly and have comorbid conditions.展开更多
基金This study was supported by the National Natural Science Foundation of China(82171544,81971251,81671329,82001406 and 81871050)Science and Technology Comission of Shanghai Municipality(19441907800,16ZR1430500,19ZR1445200,19ZR1445100,17411953100,21S31903100,2018SHZDZX01,19410710800,19411969100,19411950800)+5 种基金Shanghai Clinical Research Center for Mental Health(19MC1911100)The Clinical Research Center at Shanghai Mental Health Center(CRC2018Z001,CRC2018ZD04)Project of the Key Discipline Construction,Shanghai 3-Year Public Health Action Plan(GWV-10.1-XK18)Clinical Research Center at Shanghai Jiao Tong University School of Medicine(DLY201817,20190102)Shanghai Municipal Science and Technology Major Project(No.2018SHZDZX01,2018SHZDZX05)ZJLab.Foundation of Shanghai Mental Health Center(2020-FX-02).
文摘Background Im paired sesitwity of he soin Mlush response bo miacin is one of the most rpicated findngs in patents with schizoprenia Howewer.prior studies have usaly focused on postonset psychusis,and ll is knowm about the dinical high-risk(CHR)phase of niacin senstity in psychosis Aims To proftle and compare the miacin flush responsge among CHR individuals(converters and non-coverters)patients with frstepso schinophrenia(FES)and healty controls(HCs).Methods Sensivily 1o ftour concentralions (0.1-0001M)of aqueous methylnicotinate was tested in 105 CHR individuals,57 patients with FES and 52 HCs.CHR individuals were further grouped as converters and non converters according to the 2-year follow-up outcomes.Skin flush response scores were rated on a 4-point scale.Results Of the 105 CHR individuals,21 individuals were lost during the study,leaving 84 CHR individuals;16(19.0%)converted to full psychosis at 2 years of fllow-up.Flush response scores identifed in the CHR samples were characterised as modest degree levels,intermediate between those of HC individuals and patients with FES.The flush responses in the CHR group mimicked the responses observed in the FES group at higher concentrations(0.01 M,0.1 M)and longer time points(15 min,20min);however,these became comparable vith the responses in the HC group at the shorter time points and at lower concentr ations.The converters exhibited lower mean flush response scores than the non-converters.Conclusions Attenuated niacin-induced flushing emerged during the early phase of psychosis.New devices should be developed and verified for objective quantification of skin responses in the CHR population.
基金This research was supported by National Natural Science Foundation of China grants(81971251,81671329,81871050,82171497,82101582,82001406)Clinical Research Center at Shanghai Mental Health Center grants(CRC2018ZD01,CRC2018ZD04,CRC2018YB01,CRC2019ZD02)+6 种基金Clinical Research Center at Shanghai Jiao Tong University School of Medicine(DLY201817,20190102)Shanghai Science and Technology Committee Foundations(19411950800,16ZR1430500,19411969100,19410710800,21ZR1481500,20ZR1448600,21S31903100,19ZR14451)Shanghai Clinical Research Center for Mental Health(19MC1911100)Project of the Key Discipline Construction,Shanghai 3-Year Public Health Action Plan(GWV-10.1-XK18)Shanghai Municipal Science and Technology Major Project(2018SHZDZX01,2018SHZDZX05)and ZJ LabFoundation of Shanghai Mental Health Center(2020-FX-02)Excellent Talents Training Project of Shanghai Municipal Commission of Health(GWV-10.2-YQ44).
文摘Background Disrupted white matter(WM)microstructure has been commonly identified in youth at clinical high risk(CHR)for psychosis.Several lines of evidence suggest that fatty acids,especially unsaturated fatty acids(UFAs),might play a crucial role in the WM pathology of early onset psychosis.However,evidence linking UFA and WM microstructure in CHR is quite sparse.Aims We investigated the relationship between the plasma UFA level and WM microstructure in CHR participants and healthy controls(HC).Methods Plasma fatty acids were assessed and diffusion tensor imaging(DTI)data were performed with tract-based spatial statistics(TBSS)analysis for 66 individuals at CHR for psychosis and 70 HC.Results Both the global and regional diffusion measures showed significant between-group differences,with decreased fractional anisotropy(FA)but increased mean diffusivity(MD)and radial diffusivity(RD)found in the CHR group compared with the HC group.On top of that,we found that in the HC group,plasma arachidic acid showed obvious trend-level associations with higher global FA,lower global MD and lower global RD,which regionally spread over the corpus callosum,right anterior and superior corona radiata,bilateral anterior and posterior limb of the internal capsule,and bilateral superior longitudinal fasciculus.However,there were no associations between global WM measures and any UFA in the CHR group.Conversely,we even found negative associations between arachidic acid levels and regional FA values in the right superior longitudinal fasciculus and right retrolenticular part of the internal capsule in the CHR group.Conclusions Compared with the HC group,CHR subjects exhibited a different pattern of association between WM microstructure and plasma UFA,with a neuroprotective effect found in the HC group but not in the CHR group.Such discrepancy could be due to the excessively upregulated UFAs accumulated in the plasma of the CHR group,highlighting the role of balanced plasma-membrane fatty acids homeostasis in WM development.
基金This study was supported by the National Natural Science Foundation of China(81901832,82171544,82171497,62072014)Clinical Research Plan of SHDC(SHDC2020CR4066)+3 种基金Science and Technology Commission of Shanghai Municiality(19ZR1477800,19ZR1445200)Shanghai Key Laboratory of Psychotic Disorders(13d22260500)Clinical Research Center at Shanghai Mental Health Center(CRC2018ZD01,CRC2018ZD04 and CRC2018YB01)Shanghai Mental Health Center Foundation(2020-FX-01,2019-zd01).
文摘Background Neural oscillations directly reflect the rhythmic changes of brain activities during the resting state or while performing specific tasks.Abnormal neural oscillations have been discovered in patients with schizophrenia.However,there is limited evidence available on abnormal spontaneous neural oscillations in clinical high risk for psychosis(CHR-P).The brain signals recorded by the magnetoencephalography(MEG)technique are not to be disrupted by the skull and scalp.Methods In this study,we applied the MEG technique to record the resting-state neural activities in CHR-P.This was followed by a detailed MEG analysis method including three steps:(1)preprocessing,which was band-pass filtering based on the 0.5-60Hz frequency range,removal of 50Hz power frequency interference,and removal of electrocardiography(ECG)and electrooculography(EOG)artefacts by independent component analysis;(2)time-frequency analysis,a multitaper time-frequency transformation based on the Hanning window,and(3)source localisation.an exact low-resolution brain electromagnetic tomography.The method was verified by comparing aparticipant with CHR-P with a healthy control during the MEG recordings with an eyes-closed resting state.Results Experimental results show that the neural oscillations in CHR-P were significantly abnormal in the theta frequency band(4-7Hz)and the delta frequency band(1-3Hz).Also,relevant brain regions were located in the left occipital lobe and left temporo-occipital junction for the theta band and in the right dorsolateral prefrontal lobe and near orbitofrontal gyrus for the delta band.Conclusions Abnormal neural oscillations based on specific frequency bands and corresponding brain sources may become biomarkers for high-risk groups.Further work will validate these characteristics in CHR-P cohorts.
基金This research was supported by grants from the National Natural Science Foundation of China(82001406,81971251,81671329,81871050,82171497,82101582)Shanghai Science and Technology Committee Foundations(19ZR1445100,19411950800,16ZR1430500,19411969100,19410710800,21ZR1481500,20ZR1448600,21S31903100)+5 种基金Foundation of Shanghai Mental Health Center(2020-FX-02)Clinical Research Center at Shanghai Mental Health Center(CRC2018ZD01,CRC2018ZD04,CRC2018YB01,CRC2019ZD02)Clinical Research Center at Shanghai Jiao Tong University School of Medicine(DLY201817,20190102)Shanghai Clinical Research Center for Mental Health(19MC1911100)Project of the Key Discipline Construction,Shanghai 3-Year Public Health Action Plan(GWV-10.1-XK18)Shanghai Municipal Science and Technology Major Project(2018SHZDZX01,2018SHZDZX05)。
文摘Background Clinical high risk(CHR)of psychosis is a state in which positive symptoms cause the subjects distress but do not approach a severity level that fulfils the criteria for a psychotic episode.CHR exhibits cognitive deficits;however,the underlying neurobiological mechanisms remain unclear.This study aimed to investigate whether brain activation measured by the levels of oxygenated hemoglobin(oxy-Hb)in CHR subjects could be correlated with cognitive deficits.Methods Fifty-eight CHR individuals who fulfilled the criteria for attenuated positive syndrome as specified in the Structured Interview for Prodromal Syndrome(SIPS)and the Scale of Prodromal Syndrome(SOPS)and 58 age-and sex-matched healthy participants were included in the study.All subjects completed the Measurement and Treatment Research to Improve Cognition in Schizophrenia(MATRICS)Consensus Cognitive Battery(MCCB)that includes tests measuring attention,verbal memory,verbal fluency,executive function,and general intelligence.Functional near-infrared spectroscopy(fNIRS)was used to measure the level of oxy-Hb in the dorsolateral prefrontal and frontotemporal cortices.Results We observed significantly decreased oxy-Hb levels in channel 32(located in the right superior temporal gyrus,rSTG)within the CHR individuals compared with that in the healthy controls(HCs)(t=−3.44,Bonferroni-corrected p=0.002),indicating lower brain activity.A significant positive correlation was observed between task-relatedβvalues and working memory in the CHR group(r=0.35,p=0.008).Conclusions The brain activation of rSTG is abnormal among subjects at clinicial high risk for psychosis.This abnormality is probably associated with the neural mechanisms of deficits in the working memory during the early stage of psychosis.
基金supported by the Ministry of Science and Technology of China,National Key R&D Program of China(2016YFC1306800)National Natural Science Foundation of China(81671332,81971251,81671329,81871050,81901832,81971251,82001406,82101582,82151314,and 82171497)+9 种基金Shanghai Municipal Science and Technology Major Project(2018SHZDZX01,2018SHZDZX05)and ZJLabScience and Technology Commission of Shanghai Municipality(16JC1420200,16ZR1430500,19410710800,19411950800,19411969100,19441907800,19ZR1445100,19ZR1477800,20ZR1448600,21ZR1481500,and 21S31903100)Shanghai Municipal Health Commission(202040361)Project of the Key Discipline Construction,Shanghai 3-Year Public Health Action Plan(GWV10.1-XK18)Shanghai Clinical Research Center for Mental Health(19MC1911100)Clinical Research Plan of SHDC(SHDC2020CR4066)Clinical Research Center at Shanghai Jiao Tong University School of Medicine(DLY201817,20190102)Shanghai Jiao Tong University Foundation(ZH2018ZDB03,ZH2018QNB19)The Clinical Research Center at Shanghai Mental Health Center(CRC2018ZD01,CRC2018ZD04,CRC2018YB01,CRC2019ZD02,and 2020-FX-02)Shanghai Mental Health Center(2019-zd01).
文摘Background Self-reflectiveness,one dimension of cognitive insight,plays a protective role in an individual’s mental state.Both high and low levels of self-reflectiveness have been reported in patients with schizophrenia and individuals at clinical high risk for the illness.Aims This study aimed to explore the relationship patterns between self-reflectiveness and clinical symptoms in individuals during the pre-morbid and early clinical stages of psychosis.Methods A total of 181 subjects,including individuals with attenuated positive symptoms(APS,n=122)and patients with first-episode psychosis(FEP,n=59),completed the Beck Cognitive Insight Scale and were evaluated using the Schedule of Assessment of Insight and Positive and Negative Syndrome Scale.All subjects were classified into three groups according to their level of selfreflectiveness:low level(LSR,n=59),medium level(MSR,n=67)and high level(HSR,n=55).Both linear and nonlinear relationships between self-reflectiveness and clinical symptoms were explored.Results More individuals with APS were classified into the MSR group,while more patients with FEP were classified into the LSR group.The LSR group demonstrated less awareness of illness than the MSR and HSR groups,more stereotyped thinking and poorer impulse control but less anxiety than the MSR group,and lower levels of blunted affect and guilt feelings than the HSR group.The MSR group demonstrated lower stereotyped thinking than the HSR group.Compared to the LSR group,the MSR group had increased selfreflectiveness,improved awareness of illness,decreased stereotyped thinking,and better impulse control,but increased feelings of guilt.The HSR group showed increased stereotyped thinking when compared to the MSR group,but the other variables did not change significantly between these two groups.Overall,self-reflectiveness demonstrated an approximately inverse S-shaped relationship with the awareness of illness,a U-shaped relationship with stereotyped thinking and poor impulse control,and an almost linear relationship with anxiety and guilt feelings.Conclusions Self-reflectiveness demonstrates complex relationships with clinical symptoms and fails to exert significant positive effects when reaching a certain high level.
基金This study was supported by grants from the Municipal Hospital Frontier Technology Joint Project of Shanghai City(No.SHDC12015108)the National Natural Science Foundation of China(Nos.81830004 and 31301118).
文摘Factors associated with complete and durable remissions after anti-CD19 chimeric antigen receptor T(CAR-T)cell immunotherapy for relapsed or refractory non-Hodgkin lymphoma(r/r NHL)have not been well characterized.In this study,we found that the different sites of extranodal involvement may affect response,overall survival(OS),and progression-free survival(PFS)in patients with r/r NHL treated with anti-CD19 CAR-T cells.In a cohort of 32 treated patients,12(37.5%)and 8(25%)patients exhibited soft tissue lymphoma and bone marrow(BM)infiltrations,respectively,and 13(41%)patients exhibited infiltration at other sites.The factors that may affect prognosis were identified through multivariable analysis.As an independent risk factor,soft tissue infiltration was the only factor significantly correlated with adverse prognosis(P<0.05),whereas other factors did not reach statistical significance.Furthermore,the site of extranodal tumor infiltration significantly and negatively affected OS and PFS in patients with r/r NHL treated with anti-CD19 CAR-T cell therapy.PFS and OS in patients with BM involvement were not significantly different from those of patients with lymph node involvement alone.Thus,anti-CD19 CAR-T cell therapy may improve the prognosis of patients with BM infiltration.
基金This study was supported by grants from the Shanghai Municipal Hospital New Frontier Technology Joint Research Project(No.SHDC12015108)the National Natural Science Foundation of China(Nos.81830004,31301118,and 81272325)the Fundamental Research Funds for the Central Universities(No.22120170004).
文摘Mantle cell lymphoma(MCL)is a distinct histological type of B-cell lymphoma with a poor prognosis.Several agents,such as proteasome inhibitors,immunomodulatory drugs,and inhibitors of B cell lymphoma-2 and Bruton’s tyrosine kinase have shown efficacy for relapsed or refractory(r/r)MCL but often have short-term responses.Chimeric antigen receptor(CAR)T-cell therapy has emerged as a novel treatment modality for r/r non-Hodgkin’s lymphoma.However,long-term safety and tolerability associated with CAR T-cell therapy are not defined well,especially in MCL.In this report,we described a 70-year-old patient with r/r MCL with 48-month duration of follow-up who achieved long-term remission after CAR T-cell therapy.CAR T-cell-related toxicities were also mild and tolerated well even in this elderly patient.This report suggested that CAR T-cell therapy is a promising treatment modality for patients with MCL,who are generally elderly and have comorbid conditions.
