Нарушения гемостаза, ассоциированные с проведением терапии Т-лимфоцитами с химерным антигенным рецептором
https://doi.org/10.35754/0234-5730-2025-70-3-396-407
Аннотация
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: рассмотреть нарушения гемостаза, возникающие при проведении CAR T-клеточной терапии.
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.
Об авторах
Г. М. Галстян
ФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской Федерации
Россия
Россия
Галстян Геннадий Мартинович, доктор медицинских наук, заведующий отделением реанимации и интенсивной терапии
125167, г. Москва
Д. Ю. Костюк
ФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской Федерации
Россия
Россия
Костюк Дарья Юрьевна, аспирант отделения реанимации и интенсивной терапии
125167, г. Москва
С. А. Налбандян
ФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской Федерации
Россия
Россия
Налбандян Сирануш Ашотовна, анестезиолог-реаниматолог отделения реанимации и интенсивной терапии
125167, г. Москва
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Рецензия
Для цитирования:
Галстян Г.М., Костюк Д.Ю., Налбандян С.А. Нарушения гемостаза, ассоциированные с проведением терапии Т-лимфоцитами с химерным антигенным рецептором. Гематология и трансфузиология. 2025;70(3):396-407. https://doi.org/10.35754/0234-5730-2025-70-3-396-407
For citation:
Galstyan G.M., Kostuk D.Yu., Nalbandyan S.A. Hemostasis disorders associated with therapy with T-lymphocytes with a chimeric antigenic receptor. Russian journal of hematology and transfusiology. 2025;70(3):396-407. (In Russ.) https://doi.org/10.35754/0234-5730-2025-70-3-396-407
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