三例血液透析滤过治疗白细胞介素-6受体抑制剂治疗无效的CAR-T相关3-4级细胞因子释放综合征
[Three cases of hemodiafiltration for the treatment of CAR-T related grade 3 - 4 cytokine release syndrome after ineffective treatment with IL-6 receptor inhibitors].
作者信息
Chen S Y, Chen W H, Wan X C, Du X, Luo C R, Li X Q, Zhang X H
机构信息
Department of Hematology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China.
Protein and Cell Drug Research Center, Institute of Biomedicine and Technology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
出版信息
Zhonghua Xue Ye Xue Za Zhi. 2022 Jun 14;43(6):494-498. doi: 10.3760/cma.j.issn.0253-2727.2022.06.009.
To investigate the efficacy and safety of hemodiafiltration (HDF) in treating CAR-T related grade 3-4 cytokine release syndrome after ineffective treatment with IL-6 receptor inhibitors. Between July 2015 and July 2021, retrospective analysis of hemodiafiltration for the treatment of 3 patients, including 2 cases of acute B-lymphoblastic leukemia and 1 case of diffuse large B-cell lymphoma, with grade 3-4 CRS after CAR-T cell therapy and ineffective treatment with IL-6 receptor inhibitor was carried out. The patient's clinical symptoms, including body temperature, blood pressure, and blood oxygen, were relieved within 12 hours of all treatments, and the cytokines (IL-6, IL-10, TNF-α, INF-γ) and C-reactive protein (CRP) levels decreased significantly. No adverse side effects were observed during the follow-up period of 3 months. HDF can be a safe and feasible method to treat CAR-T related grade 3- 4 CRS after ineffective treatment with IL-6 receptor inhibitors.
探讨血液透析滤过（HDF）在白细胞介素-6受体抑制剂治疗无效后治疗CAR-T相关3-4级细胞因子释放综合征的疗效和安全性。2015年7月至2021年7月，对3例接受CAR-T细胞治疗后出现3-4级CRS且白细胞介素-6受体抑制剂治疗无效的患者进行血液透析滤过治疗的回顾性分析，其中包括2例急性B淋巴细胞白血病和1例弥漫性大B细胞淋巴瘤。所有治疗后12小时内患者的临床症状，包括体温、血压和血氧均得到缓解，细胞因子（IL-6、IL-10、TNF-α、INF-γ）和C反应蛋白（CRP）水平显著下降。在3个月的随访期内未观察到不良副作用。血液透析滤过可作为白细胞介素-6受体抑制剂治疗无效后治疗CAR-T相关3-4级CRS的一种安全可行的方法。
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