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[托珠单抗早期干预对嵌合抗原受体T细胞治疗后细胞因子释放综合征患者的影响]

[Effect of early tocilizumab intervention on patients with cytokine release syndrome following chimeric antigen receptor T cell therapy].

作者信息

Zhou L L, Ye S G, Li P, Tang X C, Liang A B

机构信息

Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2023 Dec 14;44(12):1022-1026. doi: 10.3760/cma.j.issn.0253-2727.2023.12.009.


DOI:10.3760/cma.j.issn.0253-2727.2023.12.009
PMID:38503526
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10834881/
Abstract

This study aimed to evaluate the effect of early tocilizumab intervention to relieve cytokine release syndrome (CRS) following chimeric antigen receptor T cell (CAR-T) therapy. Twenty-two patients with acute lymphoblastic leukemia who received tocilizumab to relieve CRS response after CAR-T cell infusion in our research center from October 2015 to July 2021 were retrospectively analyzed. According to the timing of tocilizumab intervention, patients were divided into the conventional and early intervention groups. Patients who received tocilizumab treatment after sustained high fever for 4 h were included in the early intervention group. The clinical data, CRS grade, and event-free survival (EFS) between the two groups were evaluated. Compared with patients who used tocilizumab after severe CRS, no patients in the early intervention group died from CRS, and there was no increased risk of neurotoxicity. Eleven patients (84.62%) achieved complete remission with minimal residual lesions. The median EFS of patients in the early intervention and conventional groups was 2 (95% 0-5) and 7 (95% 3-11) months, respectively. Early tocilizumab intervention in patients with CRS reduces severe CRS and provides a more optimized therapeutic strategy for CRS caused by CAR-T cell therapy.

摘要

本研究旨在评估早期使用托珠单抗干预对缓解嵌合抗原受体T细胞(CAR-T)治疗后细胞因子释放综合征(CRS)的效果。对2015年10月至2021年7月在本研究中心接受CAR-T细胞输注后使用托珠单抗缓解CRS反应的22例急性淋巴细胞白血病患者进行回顾性分析。根据托珠单抗干预的时机,将患者分为常规干预组和早期干预组。持续高热4小时后接受托珠单抗治疗的患者纳入早期干预组。评估两组之间的临床数据、CRS分级和无事件生存期(EFS)。与严重CRS后使用托珠单抗的患者相比,早期干预组无患者死于CRS,且神经毒性风险未增加。11例患者(84.62%)达到完全缓解,微小残留病变最少。早期干预组和常规组患者的中位EFS分别为2(95% 0-5)个月和7(95% 3-11)个月。早期对CRS患者使用托珠单抗可减轻严重CRS,并为CAR-T细胞治疗引起的CRS提供更优化的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7478/10834881/3ff181eab17c/cjh-44-12-1022-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7478/10834881/3ff181eab17c/cjh-44-12-1022-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7478/10834881/3ff181eab17c/cjh-44-12-1022-g001.jpg

相似文献

[1]
[Effect of early tocilizumab intervention on patients with cytokine release syndrome following chimeric antigen receptor T cell therapy].

Zhonghua Xue Ye Xue Za Zhi. 2023-12-14

[2]
Impact of tocilizumab on anti-CD19 chimeric antigen receptor T-cell therapy in B-cell acute lymphoblastic leukemia.

Cancer. 2024-8-1

[3]
Cardiovascular Events Among Adults Treated With Chimeric Antigen Receptor T-Cells (CAR-T).

J Am Coll Cardiol. 2019-12-24

[4]
Impact of Preemptive Use of Tocilizumab on Chimeric Antigen Receptor T Cell Outcomes in Non-Hodgkin Lymphoma.

Transplant Cell Ther. 2023-7

[5]
Early Time-to-Tocilizumab after B Cell Maturation Antigen-Directed Chimeric Antigen Receptor T Cell Therapy in Myeloma.

Transplant Cell Ther. 2021-6

[6]
Fever Characteristics and Impact on Safety and Efficacy of Chimeric Antigen Receptor T-Cell Therapy.

Clin Lymphoma Myeloma Leuk. 2023-1

[7]
Outpatient administration of CAR T-cell therapies using a strategy of no remote monitoring and early CRS intervention.

Blood Adv. 2024-8-27

[8]
Imaging-based Toxicity and Response Pattern Assessment Following CAR T-Cell Therapy.

Radiology. 2022-2

[9]
Timing of Tocilizumab Administration Under the Guidance of IL-6 in CAR-T Therapy for R/R Acute Lymphoblastic Leukemia.

Front Immunol. 2022

[10]
FDA Approval Summary: Tocilizumab for Treatment of Chimeric Antigen Receptor T Cell-Induced Severe or Life-Threatening Cytokine Release Syndrome.

Oncologist. 2018-4-5

本文引用的文献

[1]
Efficacy and safety of CD19-specific CAR T cell-based therapy in B-cell acute lymphoblastic leukemia patients with CNSL.

Blood. 2022-6-9

[2]
Disease Burden Affects Outcomes in Pediatric and Young Adult B-Cell Lymphoblastic Leukemia After Commercial Tisagenlecleucel: A Pediatric Real-World Chimeric Antigen Receptor Consortium Report.

J Clin Oncol. 2022-3-20

[3]
KTE-X19 for relapsed or refractory adult B-cell acute lymphoblastic leukaemia: phase 2 results of the single-arm, open-label, multicentre ZUMA-3 study.

Lancet. 2021-8-7

[4]
Early Time-to-Tocilizumab after B Cell Maturation Antigen-Directed Chimeric Antigen Receptor T Cell Therapy in Myeloma.

Transplant Cell Ther. 2021-6

[5]
Prognostic impact of corticosteroids on efficacy of chimeric antigen receptor T-cell therapy in large B-cell lymphoma.

Blood. 2021-6-10

[6]
Risk-Adapted Preemptive Tocilizumab to Prevent Severe Cytokine Release Syndrome After CTL019 for Pediatric B-Cell Acute Lymphoblastic Leukemia: A Prospective Clinical Trial.

J Clin Oncol. 2021-3-10

[7]
Efficacy and safety of CD19 CAR T constructed with a new anti-CD19 chimeric antigen receptor in relapsed or refractory acute lymphoblastic leukemia.

J Hematol Oncol. 2020-9-7

[8]
Preemptive mitigation of CD19 CAR T-cell cytokine release syndrome without attenuation of antileukemic efficacy.

Blood. 2019-12-12

[9]
Toxicity and response after CD19-specific CAR T-cell therapy in pediatric/young adult relapsed/refractory B-ALL.

Blood. 2019-12-26

[10]
Clinical presentation, management, and biomarkers of neurotoxicity after adoptive immunotherapy with CAR T cells.

Blood. 2019-2-26

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