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目的 探究临床药师在嵌合抗原受体T细胞治疗多发性骨髓瘤患者不良反应管理中的作用，以保障嵌合抗原受体T细胞治疗的有效性和安全性。方法 纳入2022年至2023年收治的采用嵌合抗原受体T细胞治疗的多发性骨骼瘤患者35例。临床药师参与患者嵌合抗原受体T细胞治疗的全过程，密切监测患者病情，围绕嵌合抗原受体T细胞治疗的不良反应（细胞因子释放综合征、血液系统不良反应、免疫效应细胞相关神经毒性综合征和感染）与用药问题，制订科学、可行的药学管理方案。结果 35例多发性骨骼瘤患者中，有34例（占97.14%）发生了不良反应，其中细胞因子释放综合征有11例（占31.43%），血液系统不良反应有33例（占94.30%），免疫效应细胞相关神经毒性综合征有2例（占5.71%），感染有27例（占77.15%）。所有发生不良反应的患者经临床药师参与的治疗团队积极处理后，均恢复了正常的生命体征，并顺利出院。结论 临床药师参与嵌合抗原受体T细胞治疗的全过程，在不良反应的监测与管理中发挥了重要作用，在保障嵌合抗原受体T细胞治疗有效性的前提下，提高了嵌合抗原受体T细胞治疗安全性，为临床药师参与多学科诊疗提供了参考。
Abstract：AIM To explore the role of clinical pharmacists in the management of adverse reactions in patients with multiple myeloma(MM) treated with chimeric antigen receptor T-cell(CAR-T) therapy, to ensure the efficacy and safety of CAR-T therapy. METHODS Thirty-five MM patients who received CAR-T therapy from 2022 to 2023 were enrolled. Clinical pharmacists participated in the whole process of CAR-T therapy for the patients with MM, closely monitored their conditions, and formulated scientific and feasible pharmaceutical management plans focusing on the adverse reactions(cytokine release syndrome, hematological adverse reactions, immune effector cell-associated neurotoxicity syndrome, and infection) and medication issues related to CAR-T therapy. RESULTS Among the 35 patients with MM, 34(97.14%) developed adverse reactions, including 11 cases(31.43%) of cytokine release syndrome(CRS), 33 cases(94.30%) of hematological adverse reactions, 2 cases(5.71%) of immune effector cell-associated neurotoxicity syndrome, and 27 cases(77.15%) of infection. After active treatment by the treatment team involving clinical pharmacists, all patients with adverse reactions recovered normal vital signs and were discharged smoothly. CONCLUSION Clinical pharmacists, who participate in the whole process of CAR-T therapy, play an important role in the monitoring and management of adverse reactions. On the premise of ensuring the efficacy of CAR-T therapy, their involvement improves the safety of CAR-T therapy, which provides a reference for clinical pharmacists' participation in multidisciplinary diagnosis and treatment.
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基本信息:
DOI：10.19577/j.1007-4406.2026.03.002
中图分类号:R733.3
引用信息:
[1]张翠珍,王志鹏,侯幸赟,等.临床药师在嵌合抗原受体T细胞治疗多发性骨髓瘤患者不良反应管理中的作用[J].中国临床药学杂志,2026,35(03):201-206.DOI:10.19577/j.1007-4406.2026.03.002.
基金信息:
国家自然科学基金青年科学基金项目（编号82204819）; 启航人才项目SL63
2026-03-25
2026-03-25