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

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 understandin...

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Autores principales: Yan, Zhiling, Zhang, Huanxin, Cao, Jiang, Zhang, Cheng, Liu, Hui, Huang, Hongming, Cheng, Hai, Qiao, Jianlin, Wang, Ying, Wang, Yan, Gao, Lei, Shi, Ming, Sang, Wei, Zhu, Feng, Li, Depeng, Sun, Haiying, Wu, Qingyun, Qi, Yuekun, Li, Hujun, Wang, Xiangmin, Li, Zhenyu, Liu, Hong, Zheng, Junnian, Qian, Wenbin, Zhang, Xi, Xu, Kailin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940756/
https://www.ncbi.nlm.nih.gov/pubmed/33708205
http://dx.doi.org/10.3389/fimmu.2021.611366
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author Yan, Zhiling
Zhang, Huanxin
Cao, Jiang
Zhang, Cheng
Liu, Hui
Huang, Hongming
Cheng, Hai
Qiao, Jianlin
Wang, Ying
Wang, Yan
Gao, Lei
Shi, Ming
Sang, Wei
Zhu, Feng
Li, Depeng
Sun, Haiying
Wu, Qingyun
Qi, Yuekun
Li, Hujun
Wang, Xiangmin
Li, Zhenyu
Liu, Hong
Zheng, Junnian
Qian, Wenbin
Zhang, Xi
Xu, Kailin
author_facet Yan, Zhiling
Zhang, Huanxin
Cao, Jiang
Zhang, Cheng
Liu, Hui
Huang, Hongming
Cheng, Hai
Qiao, Jianlin
Wang, Ying
Wang, Yan
Gao, Lei
Shi, Ming
Sang, Wei
Zhu, Feng
Li, Depeng
Sun, Haiying
Wu, Qingyun
Qi, Yuekun
Li, Hujun
Wang, Xiangmin
Li, Zhenyu
Liu, Hong
Zheng, Junnian
Qian, Wenbin
Zhang, Xi
Xu, Kailin
author_sort Yan, Zhiling
collection PubMed
description 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.
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spelling pubmed-79407562021-03-10 Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment Yan, Zhiling Zhang, Huanxin Cao, Jiang Zhang, Cheng Liu, Hui Huang, Hongming Cheng, Hai Qiao, Jianlin Wang, Ying Wang, Yan Gao, Lei Shi, Ming Sang, Wei Zhu, Feng Li, Depeng Sun, Haiying Wu, Qingyun Qi, Yuekun Li, Hujun Wang, Xiangmin Li, Zhenyu Liu, Hong Zheng, Junnian Qian, Wenbin Zhang, Xi Xu, Kailin Front Immunol Immunology 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. Frontiers Media S.A. 2021-02-23 /pmc/articles/PMC7940756/ /pubmed/33708205 http://dx.doi.org/10.3389/fimmu.2021.611366 Text en Copyright © 2021 Yan, Zhang, Cao, Zhang, Liu, Huang, Cheng, Qiao, Wang, Wang, Gao, Shi, Sang, Zhu, Li, Sun, Wu, Qi, Li, Wang, Li, Liu, Zheng, Qian, Zhang and Xu http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Yan, Zhiling
Zhang, Huanxin
Cao, Jiang
Zhang, Cheng
Liu, Hui
Huang, Hongming
Cheng, Hai
Qiao, Jianlin
Wang, Ying
Wang, Yan
Gao, Lei
Shi, Ming
Sang, Wei
Zhu, Feng
Li, Depeng
Sun, Haiying
Wu, Qingyun
Qi, Yuekun
Li, Hujun
Wang, Xiangmin
Li, Zhenyu
Liu, Hong
Zheng, Junnian
Qian, Wenbin
Zhang, Xi
Xu, Kailin
Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment
title Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment
title_full Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment
title_fullStr Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment
title_full_unstemmed Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment
title_short Characteristics and Risk Factors of Cytokine Release Syndrome in Chimeric Antigen Receptor T Cell Treatment
title_sort characteristics and risk factors of cytokine release syndrome in chimeric antigen receptor t cell treatment
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940756/
https://www.ncbi.nlm.nih.gov/pubmed/33708205
http://dx.doi.org/10.3389/fimmu.2021.611366
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