{"id":14602,"date":"2021-04-30T08:29:52","date_gmt":"2021-04-30T06:29:52","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=14602"},"modified":"2024-12-11T22:11:13","modified_gmt":"2024-12-11T21:11:13","slug":"une-seconde-administration-de-car-t-en-cas-dechec","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/une-seconde-administration-de-car-t-en-cas-dechec\/","title":{"rendered":"Une seconde administration de CAR T en cas d\u2019\u00e9chec ?"},"content":{"rendered":"
R\u00e9f. : HematoStat.net ; 2 (1) : R9<\/span><\/div>\n
<\/div>\n<\/p>\n
Factors associated with outcomes after a second CD19-targeted CAR T-cell 2 infusion for refractory B cell malignancies<\/span><\/em><\/strong><\/div>\n
<\/div>\n<\/p>\n
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Gauthier, J. and al. Factors associated with outcomes after a second CD19-targeted CAR T-cell infusion for refractory B-cell malignancies. Blood 137, 323\u2013335 (2021).<\/span><\/i><\/a><\/div>\n<\/div>\n
\n

R\u00e9sum\u00e9 :<\/h3>\n

En cas d\u2019\u00e9chec, une 2e <\/sup>infusion de cellules CAR T peut \u00eatre envisag\u00e9e. Les auteurs ont analys\u00e9s r\u00e9trospectivement 44 patients ayant \u00e9t\u00e9 trait\u00e9s dans des essais de phase I\/II par CAR T anti-CD19 pour des h\u00e9mopathies B et ayant b\u00e9n\u00e9fici\u00e9 d\u2019une seconde <\/sup>infusion. Le taux de r\u00e9ponse compl\u00e8te (RC) \u00e9tait respectivement de 22, 19 et 21 % (LLC=9, LNH=21 et LAL=14). Le conditionnement initial par endoxan\/fludarabine et une dose sup\u00e9rieure de cellules lors de la 2e <\/sup>administration \u00e9taient associ\u00e9s \u00e0 une meilleure \u00e9volution.<\/p>\n

Dans nos pratiques :<\/h3>\n

Alors que les traitements par CAR T se d\u00e9veloppent progressivement, selon leur h\u00e9mopathie initiale de nombreux patients vont \u00eatre confront\u00e9s \u00e0 une perte de r\u00e9ponse. Les auteurs soulignent ici la faisabilit\u00e9 d\u2019une 2e <\/sup>administration de cellules CAR T sans augmentation notable de la toxicit\u00e9. Ces r\u00e9sultats pourraient \u00e9galement influencer de futurs essais cliniques avec la possibilit\u00e9 de r\u00e9injecter des cellules afin de p\u00e9renniser la r\u00e9ponse au traitement.<\/p>\n

Le regard du statisticien :<\/strong><\/h3>\n

Le principal point critique \u00e0 faire concerne les analyses multivari\u00e9es, o\u00f9 il n\u2019est d\u2019ailleurs pas clairement explicit\u00e9 le choix des variables. De plus, il faut faire tr\u00e8s attention au nombre de variables choisies car l\u2019effectif global n\u2019est pas \u00e9lev\u00e9 (44 patients), ce qui peut alt\u00e9rer la robustesse des r\u00e9sultats (d\u2019autant qu\u2019on ignore si certaines variables sont corr\u00e9l\u00e9es entre elles). Une v\u00e9ritable \u00e9tude de phase 2 permettrait d\u00e9j\u00e0 d\u2019y voir plus clair.<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":14603,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[58,64,65],"ppma_author":[456],"class_list":["post-14602","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-car-t","tag-choix-des-variables","tag-hemopathies","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14602","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=14602"}],"version-history":[{"count":2,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14602\/revisions"}],"predecessor-version":[{"id":18314,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14602\/revisions\/18314"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=14602"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=14602"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=14602"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=14602"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}