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Pathogenesis, Diagnosis, and Management of Cytokine Release Syndrome in Patients with Cancer: Focus on Infectious Disease Considerations.

作者信息

Arvanitis Panos, Tziotis Andreas, Papadimatos Spyridon, Farmakiotis Dimitrios

机构信息

Division of Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.

Beth Israel Deaconess Medical Center Division of Gastroenterology, Boston, MA 02115, USA.

出版信息

Curr Oncol. 2025 Mar 28;32(4):198. doi: 10.3390/curroncol32040198.


DOI:10.3390/curroncol32040198
PMID:40277755
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12026323/
Abstract

Cytokine Release Syndrome (CRS) is a hyperinflammatory state triggered by immune therapies like CAR T-cell therapy and bispecific T-cell engagers (BiTEs). Characterized by excessive cytokine release, CRS often mimics infectious and inflammatory conditions, complicating diagnosis and treatment. Immunosuppressive therapies used for CRS further elevate the risk of secondary infections. A systematic search of PubMed and EMBASE was conducted using terms related to "cytokine release syndrome", "cytokine storm", "infections", and "management". Studies were included if they described infectious complications, diagnostic mimics, or therapeutic approaches related to CRS. Of 19,634 studies, 2572 abstracts were reviewed. Infections occurred in up to 23% of patients post-CAR T therapy and 24% post-BiTE therapy. Pathogens included gram-positive and gram-negative bacteria, herpesviruses (e.g., CMV, HSV), fungi (e.g., , ), and parasites (e.g., Toxoplasma gondii). CRS mimics also included non-infectious inflammatory syndromes. Differentiation remains challenging, but cytokine profiling and biomarkers (e.g., ferritin, CRP, sIL-2Rα) may aid in diagnosis. Treatments included tocilizumab, corticosteroids, and empiric antimicrobials. Prophylactic strategies were inconsistently reported. Effective CRS management requires early recognition, differentiation from infectious mimics, and collaboration between oncology and infectious disease (ID) specialists. A multidisciplinary, collaborative, and structured approach, including dedicated ID input and pre-treatment evaluation, is essential for optimizing CRS management and patient outcomes.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/ce73423a807e/curroncol-32-00198-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/39d4d81caa46/curroncol-32-00198-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/ddb3449185b7/curroncol-32-00198-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/65c4fcc32df1/curroncol-32-00198-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/e7db793a0b6b/curroncol-32-00198-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/ce73423a807e/curroncol-32-00198-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/39d4d81caa46/curroncol-32-00198-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/ddb3449185b7/curroncol-32-00198-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/65c4fcc32df1/curroncol-32-00198-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/e7db793a0b6b/curroncol-32-00198-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a556/12026323/ce73423a807e/curroncol-32-00198-g005.jpg

相似文献

[1]
Pathogenesis, Diagnosis, and Management of Cytokine Release Syndrome in Patients with Cancer: Focus on Infectious Disease Considerations.

Curr Oncol. 2025-3-28

[2]
Management Principles Associated With Cytokine Release Syndrome.

Semin Oncol Nurs. 2019-8-31

[3]
Cytokine release syndrome and cancer immunotherapies - historical challenges and promising futures.

Front Immunol. 2023

[4]
Need for aligning the definition and reporting of cytokine release syndrome (CRS) in immuno-oncology clinical trials.

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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
The role of C-reactive protein and ferritin in the diagnosis of HLH, adult-onset still's disease, and COVID-19 cytokine storm.

Sci Rep. 2024-12-28

[2]
Early versus late infectious complications following chimeric antigen receptor-modified T-cell therapy.

Leuk Lymphoma. 2025-4

[3]
The Heterogeneous Syndrome of Noninfectious Causes of Persistent Fever in Neutropenic Patients With Hematologic Malignancy: Another Opportunity for Stewardship?

Clin Infect Dis. 2024-12-17

[4]
Cytokine release syndrome following COVID-19 infection during treatment with nivolumab for cancer of esophagogastric junction carcinoma: a case report and review.

Int J Emerg Med. 2024-9-2

[5]
Management of chimeric antigen receptor T (CAR-T) cell-associated toxicities.

Intensive Care Med. 2024-9

[6]
Management of Toxicities Associated with BCMA, GPRC5D, and FcRH5-Targeting Bispecific Antibodies in Multiple Myeloma.

Curr Hematol Malig Rep. 2024-12

[7]
IL-2 based cancer immunotherapies: an evolving paradigm.

Front Immunol. 2024-7-24

[8]
Novel prognostic scoring systems for severe CRS and ICANS after anti-CD19 CAR T cells in large B-cell lymphoma.

J Hematol Oncol. 2024-8-6

[9]
Riding the storm: managing cytokine-related toxicities in CAR-T cell therapy.

Semin Immunopathol. 2024-7-16

[10]
Progressive Multifocal Leukoencephalopathy Unmasked by Teclistamab in a Refractory Multiple Myeloma Patient.

Curr Oncol. 2024-5-9

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