Prognostic Significance of Cytokine Release Syndrome in B Cell Hematological Malignancies Patients After Chimeric Antigen Receptor T Cell Therapy

J Interferon Cytokine Res. 2021 Dec;41(12):469-476. doi: 10.1089/jir.2021.0057.

Abstract

Cytokine release syndrome (CRS) is the most common on-target toxicity of chimeric antigen receptor (CAR) T cell therapy. However, the prognostic significance of CRS has not been well elucidated. The aim of our study was to evaluate the association between CRS and efficacy after anti-CD19 CAR-T therapy in a retrospective cohort of 22 patients with relapsed/refractory B cell hematological malignancies. The complete remission (CR) rates after CAR-T therapy were 68%, and median value for progression-free survival (PFS) was 6.8 months. Eight of 22 (36.4%) patients showed ≥ grade 2 CRS. Statistical analysis found that patients with ≥ grade 2 CRS had higher CR rates and longer PFS than those with < grade 2 CRS. Moreover, bridging hematopoietic stem cell transplantation was another independent predictor for PFS. These data suggested that appropriate CRS may be beneficial to the efficacy of CAR-T therapy. The Clinical Trial Registration number is NCT03110640, NCT03302403.

Keywords: acute lymphoblastic leukemia; chimeric antigen receptor T cells; cytokine release syndrome; non-Hodgkin lymphoma; prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers
  • Cytokine Release Syndrome / etiology*
  • Cytokine Release Syndrome / mortality*
  • Disease Susceptibility
  • Female
  • Humans
  • Immunotherapy, Adoptive / adverse effects*
  • Immunotherapy, Adoptive / methods
  • Leukemia, B-Cell / complications*
  • Leukemia, B-Cell / diagnosis
  • Leukemia, B-Cell / mortality*
  • Leukemia, B-Cell / therapy
  • Lymphoma, B-Cell / complications*
  • Lymphoma, B-Cell / diagnosis
  • Lymphoma, B-Cell / mortality*
  • Lymphoma, B-Cell / therapy
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Young Adult

Substances

  • Biomarkers

Associated data

  • ClinicalTrials.gov/NCT03110640
  • ClinicalTrials.gov/NCT03302403