Article information
Abstract
Immunotherapy has produced a revolution in the treatment of cancer. It involves manipulating the patient's immune system to identify and destroy malignant cells. There has been an explosion in the development of these therapies in recent decades, with the emergence of monoclonal and bispecific antibodies, immune checkpoint inhibitors, and cellular therapies, including T cells modified with a chimeric antigen receptor (CAR-T cells) and tumor-infiltrating lymphocytes (TILs). While these new therapies offer new hope to patients, they have also introduced a new profile of adverse effects, resulting from the action of a hyperactive immune system, such as infusion reactions, autoimmune phenomena, cytokine release syndrome, and neurotoxicity associated with immune effector therapies, as well as capillary leak syndrome.
Keywords:
Immunotherapy
Critically ill hematological cancer patient
Monoclonal antibodies
Immune checkpoint inhibitors
CAR-T
TIL
Allogeneic transplantation
Cytokine release syndrome
Immunotherapy-associated neurotoxicity
Resumen
La inmunoterapia ha supuesto una revolución en el tratamiento de las neoplasias. Su acción se fundamenta en la manipulación del sistema inmune del paciente para identificar y destruir las células malignas. En las últimas décadas hemos asistido a una explosión en el desarrollo de estas terapias, con la aparición de anticuerpos monoclonales y biespecíficos, inhibidores de los puntos de control inmunitario y terapias celulares, incluyendo las células T modificadas con un receptor antigénico quimérico (CAR-T) y los linfocitos infiltrantes de tumor (TILs). Estas nuevas terapias han supuesto nuevas esperanzas para los pacientes, pero también han traído un nuevo perfil de efectos adversos, derivados de la acción de un sistema inmune hiperactivo, como reaccciones infusionales, fenómenos autoinmunes, síndrome de liberación de citoquinas y la neurotoxidad associada a terapias inmunoefectoras, y el síndrome de fuga capilar.
Palabras clave:
Inmunoterapia
Paciente oncohematológico crítico
Anticuerpos monoclonales
Inhibidores punto de control inmunitario
CAR-T
TILs
Trasplante alogénico
Síndrome de liberación de citoquinas
Neurotoxicidad asociada a inmunoterapia
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