Cytokine release syndrome and relevant factors of CD19 targeted chimeric antigen receptor T cell therapy in relapsed/refractory B cell hematological malignancies.

Abstract

OBJECTIVES AND METHODS:

We reviewed the outcomes of 77 episodes of CD19 CAR-T therapy in 67 patients with B cell hematological malignancies from October 2016 to January 2020. Factors related to the grade of cytokine release syndrome (CRS) were explored by multivariate analysis, nonparametric test was conducted to explore the correlation between CRS and response. Kaplan-Meier curves were used to indicate survival profiles, and the correlation between CRS and survival was determined by the log-rank test.

RESULTS:

The rate of complete remission (CR) was 74.0% (57/77). CRS of any grade occurred in 68 of 77 episodes (grade 1: 32.5%, grade 2: 24.7%, grade 3: 22.1%, grade 4: 6.5%, grade 5: 2.6%). Patients with a history of transplantation had less severe CRS, and dose escalation-based infusion reduced the severity of CRS. Severe CRS was related to a higher CR rate but had no significant impact on event-free survival (EFS), relapse-free survival (RFS), or overall survival (OS).

CONCLUSION:

As a common adverse reaction of CAR-T therapy, the severity of CRS can be alleviated by dose escalation infusion, a history of transplantation was correlated with less severe CRS. Severe CRS was related to better response but was unrelated to long-term survival.

• Authors: Qian-Wen Xu, Hui Xu, Lei Xue, Li Wang, Xu-Han Zhang, Kai-di Song, Wen Yao, Xiang Wan, Juan Tong, Hui-Lan Liu, Xin Liu, Xiao-Yu Zhu, Zi-Min Sun, Xing-Bing Wang
• Journal: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis (Transfus Apher Sci) Vol. 61 Issue 6 Pg. 103473 (Dec 2022) ISSN: 1473-0502 [Print] England
• PMID: 35672235 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier Ltd.

Chemical References

• Antigens, CD19
• Receptors, Chimeric Antigen

Topics

• Humans
• Antigens, CD19 (therapeutic use)
• Cell- and Tissue-Based Therapy
• Cytokine Release Syndrome
• Hematologic Neoplasms (therapy)
• Neoplasm Recurrence, Local (drug therapy)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (therapy)
• Receptors, Chimeric Antigen