Back to Search
Start Over
A distinct cytokine network distinguishes chimeric antigen receptor T cell (CAR-T)–associated hemophagocytic lymphohistiocytosis-like toxicity (carHLH) from severe cytokine release syndrome following CAR-T therapy.
- Source :
-
Cytotherapy (Elsevier Inc.) . Nov2023, Vol. 25 Issue 11, p1167-1175. 9p. - Publication Year :
- 2023
-
Abstract
- With the increasing application of chimeric antigen receptor (CAR)-T cell therapy in various malignancies, an extra toxicity profile has been revealed, including a severe complication resembling hemophagocytic lymphohistiocytosis (HLH), which is usually disguised by severe cytokine release syndrome (CRS). In a clinical trial in whom 99 patients received B-cell maturation antigen CAR-T cells, we identified 20 (20.20%) cases of CAR-T cell–associated HLH (carHLH), most of whom possessed a background of severe CRS (grade ≥3). The overlapping features of carHLH and severe CRS attracted us to further explore the differences between them. We showed that carHLH can be distinguished by extreme elevation of interferon-γ, granzyme B, interleukin-1RA and interleukin-10, which can be informative in developing prevention and management strategies of this toxicity. Moreover, we developed a predictive model of carHLH with a mean area under the curve of 0.81 ± 0.07, incorporating serum lactate dehydrogenase at day 6 post-CRS and serum fibrinogen at day 3 post-CRS. The incidence of carHLH in CAR-T recipients might be relatively higher than we previously thought. relatively higher than we previously. A cytokine network distinguished from CRS is responsible for carHLH. And corresponding cytokine-directed therapies, especially targeting IL-10, are worth trying. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14653249
- Volume :
- 25
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Cytotherapy (Elsevier Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 173234307
- Full Text :
- https://doi.org/10.1016/j.jcyt.2023.06.008