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

被引：56

作者：

Yan, Zhiling ^{[1
,2
]}

Zhang, Huanxin ^{[1
,2
]}

Cao, Jiang ^{[1
,2
]}

Zhang, Cheng ^{[3
]}

Liu, Hui ^{[4
,10
]}

Huang, Hongming ^{[5
]}

Cheng, Hai ^{[1
,2
]}

Qiao, Jianlin ^{[2
]}

Wang, Ying ^{[1
,2
]}

Wang, Yan ^{[6
]}

Gao, Lei ^{[3
]}

Shi, Ming ^{[7
,8
,9
]}

Sang, Wei ^{[1
,2
]}

Zhu, Feng ^{[1
,2
]}

Li, Depeng ^{[1
,2
]}

Sun, Haiying ^{[1
,2
]}

Wu, Qingyun ^{[2
]}

Qi, Yuekun ^{[1
,2
]}

Li, Hujun ^{[1
,2
]}

Wang, Xiangmin ^{[1
,2
]}

Li, Zhenyu ^{[1
,2
]}

Liu, Hong ^{[6
]}

Zheng, Junnian ^{[7
,8
,9
]}

Qian, Wenbin ^{[4
,10
]}

Zhang, Xi ^{[3
]}

Xu, Kailin ^{[1
,2
]}

机构：

[1] Xuzhou Med Univ, Affiliated Hosp, Dept Hematol, Xuzhou, Jiangsu, Peoples R China

[2] Xuzhou Med Univ, Blood Dis Inst, Key Lab Bone Marrow Stem Cell, Xuzhou, Jiangsu, Peoples R China

[3] Army Med Univ, State Key Lab Trauma Burn & Combined Injury, Xinqiao Hosp, Med Ctr Hematol, Chongqing, Peoples R China

[4] Zhejiang Univ, Inst Hematol, Hangzhou, Peoples R China

[5] Nantong Univ, Affiliated Hosp, Dept Hematol, Nantong, Peoples R China

[6] Xuzhou Med Univ, Blood Dis Inst, Xuzhou, Jiangsu, Peoples R China

[7] Xuzhou Med Univ, Canc Inst, Xuzhou, Jiangsu, Peoples R China

[8] Xuzhou Med Univ, Canc Inst, Jiangsu Ctr Collaborat & Innovat Canc Biotherapy, Xuzhou, Jiangsu, Peoples R China

[9] Xuzhou Med Univ, Affiliated Hosp, Ctr Clin Oncol, Xuzhou, Jiangsu, Peoples R China

[10] Zhejiang Univ, Affiliated Hosp 2, Coll Med, Dept Hematol, Hangzhou, Peoples R China

来源：

FRONTIERS IN IMMUNOLOGY | 2021年 / 12卷

基金：

中国国家自然科学基金; 中国博士后科学基金;

关键词：

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

D O I：

10.3389/fimmu.2021.611366

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

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.

引用

页数：8

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