Recommendations for the timing, dosage, and usage of corticosteroids during cytokine release syndrome (CRS) caused by chimeric antigen receptor (CAR)-T cell therapy for hematologic malignancies

In the ZUMA-1 study, cohorts 4 and 6 supported the prophylactic and early use of corticosteroids, as this approach reduced the cumulative dose of corticosteroids, did not affect the complete response (CR) rate or survival from CAR-T cell therapy, and decreased the incidence of severe CRS. In another study conducted by MD Anderson, a retrospective analysis of 100 patients treated with Axi-Cel at a single center explored the impact of corticosteroids on clinical outcomes in patients with relapsed or refractory large B-cell lymphoma receiving standard CD19 CAR-T cell therapy. [3] Although the study indicated that the dosage, duration, and timing of corticosteroid treatment did not affect CAR-T cell expansion, further research is needed to assess the impact of these factors on the cytotoxic activity of CAR-T cells and on cytokine production and trafficking. [...]we understand the underlying mechanisms, cautious use of corticosteroids, with a focus on delaying their initiation and limiting their cumulative dose and duration depending on the clinical situation, might be prudent. Aibin Liang, Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China E-Mail: lab7182@tongji.edu.cn; Weidong Han, Department of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, China E-Mail: hanwdrsw@163.com; Xiaojun Huang, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, No. 11 South Street of Xizhimen, Xicheng District, Beijing 100044, China E-Mail: huangxiaojun@bjmu.edu.cn How to cite this article: