Prevalence and factors associated with anxiety and depressive symptoms among patients hospitalized with hematological malignancies after chimeric antigen receptor T-cell (CAR-T) therapy: A cross-sectional study

2021 ◽  
Vol 286 ◽  
pp. 33-39
Author(s):  
Hongyuan Dai ◽  
Shuya Xu ◽  
Jing Han ◽  
Zhenyu Li ◽  
Jiang Cao ◽  
...  
Immunotherapy ◽  
2020 ◽  
Vol 12 (18) ◽  
pp. 1341-1357
Author(s):  
Nashwa El-Khazragy ◽  
Sherief Ghozy ◽  
Passant Emad ◽  
Mariam Mourad ◽  
Diaaeldeen Razza ◽  
...  

Taking advantage of the cellular immune system is the mainstay of the adoptive cell therapy, to induce recognition and destruction of cancer cells. The impressive demonstration of this principle is chimeric antigen receptor-modified T (CAR-T)-cell therapy, which had a major impact on treating relapsed and refractory hematological malignancies. Despite the great results of the CAR-T-cell therapy, many tumors are still able to avoid immune detection and further elimination, as well as the possible associated adverse events. Herein, we highlighted the recent advances in CAR-T-cell therapy, discussing their applications beneficial functions and side effects in hematological malignancies, illustrating the underlying challenges and opportunities. Furthermore, we provide an overview to overcome different obstacles using potential manufacture and treatment strategies.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Chunyi Shen ◽  
Zhen Zhang ◽  
Yi Zhang

Immunotherapy, especially based on chimeric antigen receptor (CAR) T cells, has achieved prominent success in the treatment of hematological malignancies. However, approximately 30-50% of patients will have disease relapse following remission after receiving CD19-targeting CAR-T cells, with failure of maintaining a long-term effect. Mechanisms underlying CAR-T therapy inefficiency consist of loss or modulation of target antigen and CAR-T cell poor persistence which mostly results from T cell exhaustion. The unique features and restoration strategies of exhausted T cells (Tex) have been well described in solid tumors. However, the overview associated with CAR-T cell exhaustion is relatively rare in hematological malignancies. In this review, we summarize the characteristics, cellular, and molecular mechanisms of Tex cells as well as approaches to reverse CAR-T cell exhaustion in hematological malignancies, providing novel strategies for immunotherapies.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e019918 ◽  
Author(s):  
Chanrith Ngin ◽  
Khuondyla Pal ◽  
Sovannary Tuot ◽  
Pheak Chhoun ◽  
Rosa Yi ◽  
...  

ObjectiveTo explore social and behavioural factors associated with depressive symptoms among university students in Cambodia.DesignCross-sectional study.SettingsTwo public universities—one in the capital city of Phnom Penh and another in Battambang provincial town.ParticipantsThis study included 1359 students randomly selected from all departments in the two universities using a multistage cluster sampling method for a self-administered questionnaire survey in 2015.Primary outcome measureDepressive symptoms measured by using the Center for Epidemiologic Studies Depression scale. All measures in the study were self-reported.ResultsThe proportion of students with depressive symptoms and severe depressive symptoms were 50.6% and 19.6%, respectively. After adjustment in multivariate logistic regression analysis, depressive symptoms remained significantly associated with poor academic performance (adjusted OR (AOR)=7.31, 95% CI 2.24 to 23.86), higher consumption of unhealthy food (AOR=1.72, 95% CI 1.08 to 2.76), a negative self-perception about body shape (AOR=0.54, 95% CI 0.29 to 0.99) and general health status (AOR=2.99, 95% CI 1.28 to 7.00), and limited physical activeness (AOR=0.30, 95% CI 0.16 to 0.58). Depressive symptoms also remained significantly associated with adverse childhood experiences including physical violence (AOR=1.39, 95% CI 1.04 to 1.86), psychological abuse (AOR=1.82, 95% CI 1.37 to 2.42) and lack of general and medical care (AOR=0.51, 95% CI 0.30 to 0.86) by family during childhood.ConclusionsThe key factors associated with depressive symptoms were family related and individual behaviours and attitudes. Thus, efforts should be invested in comprehensive screening and intervention programmes to diagnose those vulnerable students early, offer immediate treatment and cater appropriate support.


Pharmaceutics ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 194 ◽  
Author(s):  
Gils Roex ◽  
Tom Feys ◽  
Yves Beguin ◽  
Tessa Kerre ◽  
Xavier Poiré ◽  
...  

Chimeric antigen receptor (CAR)-T-cell therapy is an innovative form of adoptive cell therapy that has revolutionized the treatment of certain hematological malignancies, including B-cell non-Hodgkin lymphoma (NHL) and B-cell acute lymphoblastic leukemia (ALL). The treatment is currently also being studied in other B-cell neoplasms, including multiple myeloma (MM) and chronic lymphocytic leukemia (CLL). CD19 and B-cell maturation antigen (BCMA) have been the most popular target antigens for CAR-T-cell immunotherapy of these malignancies. This review will discuss the efficacy and toxicity data from the pivotal clinical studies of CD19- and BCMA-targeted CAR-T-cell therapies in relapsed/refractory B-cell malignancies (NHL, ALL, CLL) and MM, respectively.


Author(s):  
Melanie Schwerdtfeger ◽  
Mohamed-Reda Benmebarek ◽  
Stefan Endres ◽  
Marion Subklewe ◽  
Vincenzo Desiderio ◽  
...  

Abstract Purpose of Review Both chimeric antigen receptor (CAR) T cells and T cell–engaging antibodies (BiAb) have been approved for the treatment of hematological malignancies. However, despite targeting the same antigen, they represent very different classes of therapeutics, each with its distinct advantages and drawbacks. In this review, we compare BiAb and CAR T cells with regard to their mechanism of action, manufacturing, and clinical application. In addition, we present novel strategies to overcome limitations of either approach and to combine the best of both worlds. Recent Findings By now there are multiple approaches combining the advantages of BiAb and CAR T cells. A major area of research is the application of both formats for solid tumor entities. This includes improving the infiltration of T cells into the tumor, counteracting immunosuppression in the tumor microenvironment, targeting antigen heterogeneity, and limiting off-tumor on-target effects. Summary BiAb come with the major advantage of being an off-the-shelf product and are more controllable because of their half-life. They have also been reported to induce less frequent and less severe adverse events. CAR T cells in turn demonstrate superior response rates, have the potential for long-term persistence, and can be additionally genetically modified to overcome some of their limitations, e.g., to make them more controllable.


2021 ◽  
Author(s):  
Tanvir Abir ◽  
Nazmul Ahsan Kalimullah ◽  
L Osuagwu Uchechukwu ◽  
Dewan Muhammad Nur-A Yazdani ◽  
Taha Husain ◽  
...  

AbstractBackgroundFeelings of isolation, insecurity, and instability triggered by COVID-19 could have a long-term impact on the mental health status of individuals. This study examined the prevalence and factors associated with the mental health symptoms of anxiety, depression, and stress during the COVID-19 pandemic in Bangladesh.MethodsFrom 1st – 30th April 2020, we used a validated self-administered questionnaire to conduct a cross-sectional study on 10,609 participants through an online survey platform. We assessed mental health status using the Depression, Anxiety, and Stress Scale (DASS-21). The total depression, anxiety, and stress subscale scores were divided into normal, mild, moderate, severe, and multinomial logistic regression was used to examine associated factors.ResultsThe prevalence of depressive symptoms was 15%, 34%, and 15% for mild, moderate, and severe depressive symptoms, respectively. The prevalence of anxiety symptoms was 59% for severe anxiety symptoms, 14% for moderate anxiety symptoms, and 14% for mild anxiety symptoms while, the prevalence for stress levels were 16% for severe stress level, 22% for moderate stress level and 13% for mild stress level. Multivariate analyses revealed that the most consistent factors associated with mild, moderate, and severe of the three mental health subscales (depression, anxiety, and stress) were respondents who lived in Dhaka and Rangpur division, females, those who self-quarantine in the previous 7 days before the survey and those respondents who experienced chills, breathing difficulty, dizziness, and sore throat.ConclusionOur results showed that about 64%, 87%, and 61% experienced depressive symptoms, anxiety symptoms, and levels of stress, respectively. In Bangladesh, there is a need for better mental health support for females especially those that lived in Dhaka and Rangpur division and experienced chills, breathing difficulty, dizziness, and sore throat during COVID-19 and other future pandemics.


2021 ◽  
Vol 30 ◽  
Author(s):  
Fernanda Maria Vieira Pereira-Ávila ◽  
Simon Ching Lam ◽  
Maithê de Carvalho e Lemos Goulart ◽  
Fernanda Garcia Bezerra Góes ◽  
Natália Maria Vieira Pereira-Caldeira ◽  
...  

ABSTRACT Objective: to identify factors associated with depressive symptoms among older adults during the COVID-19 pandemic. Method: a cross-sectional study developed in all regions of Brazil, using an electronic form among older adults aged 60 or over. Data were collected from April 17 to May 15, 2020. Measures of central tendency and dispersion were used. For comparison of means, Student’s t-test and analysis of variance were applied, considering p≤0.05. For association of factors, chi-square was adopted with bivariate analyzes and logistic regression. Results: nine hundred (100.0%) older adults participated in the study. The general score for symptoms of depression was 3.8 (SD=4.4), 818 (91.9%) had no or mild depressive symptoms. Women (p <0.01) have more symptoms than men. The income variable is a predictor of depressive symptoms (OR=0.56; CI: 0.34-0.91; p=0.020). Conclusion: the main factors associated with symptoms of depression were sex, income, education and occupations that expose them to COVID-19 had the highest depression scores.


2019 ◽  
Vol 28 (4) ◽  
pp. 243-251
Author(s):  
Grace Sum ◽  
Yun Ru Tan ◽  
Song-Iee Hong ◽  
Gerald Choon-Huat Koh

Background: There is a rapidly ageing population globally, leading to a rise in subsidised public housing in many countries for older adults. According to the World Health Organisation, depression is the most prevalent mental disorder in older adults. There is a gap in literature on the factors associated with depression in those residing in studio apartments for older adults, characterised by small living spaces and isolated community settings. Objective: The aim of this study was to examine the associations between socio-demographic variables, social support, self-perceived health and mental status, life satisfaction, exercise, physical functioning, chronic conditions, and the use of eldercare services, with depressive symptoms. Methods: We utilised a cross-sectional study of older adults aged ⩾55 years residing in Singapore’s studio apartments. Multivariable logistic regression was applied. Results: Widowhood was associated with depressive symptoms, compared to being married or having a domestic partner (adjusted odds ratio (AOR) = 1.70, 95% confidence interval (CI) = 1.01 to 2.86). Odds of depressive symptoms were associated with difficulty bathing and showering (AOR = 3.74, 95% CI = 1.06 to 13.21). Depressive symptoms were associated with cataract (AOR = 1.67, 95% CI = 1.01 to 2.77) and urinary tract disorder (AOR = 4.70, 95% CI = 1.21 to 18.26). There were dose-response relationships between higher odds of depressive symptoms and poorer social support, self-perceived mental health, life satisfaction, and exercise behaviour ( p for trend < 0.001). Conclusion: Factors including widowhood, physical functioning difficulty, chronic conditions, low social support, low self-perceived mental health, poor life satisfaction, and lack of exercise behaviour, were associated with depressive symptoms in older adults residing in studio apartments. More attention is needed to care for the psychosocial and physical needs of older adults in studio apartments.


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