Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment

Frontiers in Immunology

Hong Liu²  Yan Wang²  Ming Shi⁴  Junnian Zheng⁴  Hongming Huang⁵  Wenbin Qian⁶  Hui Liu⁶  Kailin Xu⁸  Huanxin Zhang⁸  Hai Cheng⁸  Qingyun Wu⁸  Jiang Cao⁸  Ying Wang⁸  Zhenyu Li⁸  Yuekun Qi⁸  Haiying Sun⁸  Feng Zhu⁸  Xiangmin Wang⁸  Jianlin Qiao⁸  Hujun Li⁸  Depeng Li⁸  Wei Sang⁸  Zhiling Yan⁸  Xi Zhang⁹  Cheng Zhang⁹  Lei Gao⁹ 

[1] Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China;Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China;Cancer Institute, Xuzhou Medical University, Xuzhou, China;Center of Clinical Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China;Department of Hematology, The Affiliated Hospital of Nantong University, Nantong, China;Institute of Hematology, Zhejiang University, Hangzhou, China;Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute, Xuzhou Medical University, Xuzhou, China;Key Laboratory of Bone Marrow Stem Cell, Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China;Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing, China;

关键词: cytokine release syndrome;    chimeric antigen receptor T cell;    acute lymphocyte leukemia;    lymphoma;    multiple myeloma;   

DOI  :  10.3389/fimmu.2021.611366

来源: DOAJ

【 摘 要 】

Clinical trials have confirmed that chimeric antigen receptor (CAR) T cell therapies are revolutionizing approaches for treating several relapsed or refractory hematological tumors. Cytokine release syndrome (CRS) is an adverse event with high incidence during CAR-T treatment. A further understanding of the characteristics and related risk factors of CRS is important for effective management. A total of 142 patients with relapsed or refractory acute lymphocyte leukemia (ALL), lymphoma, or multiple myeloma (MM) received lymphodepletion chemotherapy followed by infusion of CAR-T cells. The characteristics of CRS at different time points after treatment were monitored and risk factors were analyzed. The incidence of CRS for ALL, lymphoma, and multiple myeloma were 82%, 90%, and 90% respectively. Fever was observed on a median of day 3 for ALL, day 1 for lymphoma, and day 8.5 for MM after CAR-T cell infusion, and the duration was different between grade 1–2 CRS and grade 3–5 CRS. Disease types, peak concentration of IL-6, and CRP were associated with CRS. For patients with ALL, numbers of lymphoblast in bone marrow before lymphodepletion, peak concentration of IL-6, and CRP were independent risk factors of CRS. Clinical stage of lymphoma patients and high tumor burden in marrow of MM patients were independent risk factors of CRS. In conclusion, the characteristics and risk factors of CRS in different B-cell hematological tumors are different and should be managed individually during CAR-T cell therapy.

【 授权许可】

Unknown