bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2025-70-3-396-407bloodjour-665Research ArticleОБЗОРЫREVIEWSНарушения гемостаза, ассоциированные с проведением терапии Т-лимфоцитами с химерным антигенным рецепторомHemostasis disorders associated with therapy with T-lymphocytes with a chimeric antigenic receptorhttps://orcid.org/0000-0001-8818-8949ГалстянГ. М.GalstyanG. M.

Галстян Геннадий Мартинович, доктор медицинских наук, заведующий отделением реанимации и интенсивной терапии

125167, г. Москва

Gennadiy M. Galstyan, Dr. Sci. (Med.), Head of the Resuscitation and Intensive Care Department

125167, Moscow

gengalst@gmail.comhttps://orcid.org/0009-0002-3984-3702КостюкД. Ю.KostukD. Yu.

Костюк Дарья Юрьевна, аспирант отделения реанимации и интенсивной терапии

125167, г. Москва

Daria Yu. Kostyuk, Postgraduate Student, Resuscitation and Intensive Care Department

125167, Moscow

kostyuk.dash@yandex.ruhttps://orcid.org/0000-0002-3009-156XНалбандянС. А.NalbandyanS. A.

Налбандян Сирануш Ашотовна, анестезиолог-реаниматолог отделения реанимации и интенсивной терапии

125167, г. Москва

Siranush A. Nalbandyan, Physician, Resuscitation and Intensive Care Department

125167, Moscow

siranushik1995@gmail.comФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской ФедерацииРоссияNational Medical Research Center for HematologyRussian Federation202505102025703396407Copyright © Галстян Г.М., Костюк Д.Ю., Налбандян С.А., 20252025Галстян Г.М., Костюк Д.Ю., Налбандян С.А.Galstyan G.M., Kostuk D.Y., Nalbandyan S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/665Введение

Введение. Терапия T-лимфоцитами с химерным антигенным рецептором (Chimeric Antigen Receptor T-Cells, CAR T) является эффективным методом лечения рецидивов/резистентных форм (Р/Р) лимфопролиферативных заболеваний. Нарушения гемостаза могут осложнять CAR T-клеточную терапию.

Цель

Цель: рассмотреть нарушения гемостаза, возникающие при проведении CAR T-клеточной терапии.

Основные сведения

Основные сведения. При CAR T-клеточной терапии возникают нарушения как тромбоцитарного, так и плазменного звеньев гемостаза. CAR T-ассоциированная тромбоцитопения может быть ранней (от 0 до +30 дня), поздней (от 31-го до 90-го дня), персистирующей (после +90 дня). Для лечения применяют как трансфузии концентратов тромбоцитов, так и в ряде случаев агонисты тромбопоэтиновых рецепторов. Коагуляционные нарушения проявляются как геморрагическим синдромом, так и тромбоэмболическими осложнениями. Тактика гемостатической и антикоагулянтной терапии до сих пор не разработана.

Introduction

Introduction. Chimeric Antigen Receptor T-cell (CAR-T) therapy is an effective treatment for relapsed/refractory (R/R) lymphoproliferative diseases. Hemostasis disorders can complicate CAR T-cell therapy.

Aim

Aim: to examine hemostatic disorders arising during CAR T-cell therapy.

Main fi ndings

Main fi ndings. CAR T-cell therapy leads to disorders of both the platelet and plasma components of hemostasis. CAR T-associated thrombocytopenia can be early (from day 0 to +30), late (from day 31 to 90), or persistent (after day +90). Treatment involves both platelet concentrate transfusions and, in some cases, thrombopoietin receptor agonists. Coagulation disorders manifest as both hemorrhagic syndrome and thromboembolic complications. Guidelines for hemostatic and anticoagulant therapy have not yet been established.

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The authors declare that there are no conflicts of interest present.