Effect of early tocilizumab intervention on patients with cytokine release syndrome following chimeric antigen receptor T cell therapy
10.3760/cma.j.issn.0253-2727.2023.12.009
- VernacularTitle:托珠单抗早期干预细胞因子释放综合征对嵌合抗原受体T细胞治疗的影响
- Author:
Lili ZHOU
1
;
Shiguang YE
;
Ping LI
;
Xiaochen TANG
;
Aibin LIANG
Author Information
1. 同济大学附属同济医院血液科，上海 200065
- Keywords:
Cytokine release syndrome;
Chimeric antigen receptor T cell;
Tocilizumab
- From:
Chinese Journal of Hematology
2023;44(12):1022-1026
- CountryChina
- Language:Chinese
-
Abstract:
Objective: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.Methods: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.Results: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% CI 0-5) and 7 (95% CI 3-11) months, respectively. Conclusion: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.
