Potential Role of IFNγ Inhibition in Refractory Cytokine Release Syndrome Associated with CAR T-cell Therapy

Potential Role of IFNγ Inhibition in Refractory Cytokine Release Syndrome Associated with CAR T-cell Therapy

Here we review the pathophysiology and management of cytokine release syndrome (CRS) secondary to immunotherapy, and potential options for CRS refractory to IL6 inhibition and glucocorticoids, for which there are no proven treatments. To illustrate, we describe a patient with B-cell acute lymphoblas...

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Veröffentlicht in:Blood cancer discovery 2022-03, Vol.3 (2), p.90-94
Hauptverfasser: McNerney, Kevin O, DiNofia, Amanda M, Teachey, David T, Grupp, Stephan A, Maude, Shannon L
Format: Artikel
Sprache:eng
Schlagworte:
Cytokine Release Syndrome - drug therapy
Hematologic Neoplasms
Humans
Immunotherapy, Adoptive - adverse effects
In Focus
Interferon-gamma
Macrophage Activation
Receptors, Chimeric Antigen - immunology
T-Lymphocytes
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Zusammenfassung:Here we review the pathophysiology and management of cytokine release syndrome (CRS) secondary to immunotherapy, and potential options for CRS refractory to IL6 inhibition and glucocorticoids, for which there are no proven treatments. To illustrate, we describe a patient with B-cell acute lymphoblastic leukemia who developed refractory grade 4 CRS following CD19-directed chimeric antigen receptor T-cell therapy, treated with tocilizumab, methylprednisolone, siltuximab, and the IFNγ inhibitor emapalumab, with complete remission from leukemia for 12 months. See related article by Bailey et al., p. 136 (15).
ISSN:2643-3230
2643-3249
DOI:10.1158/2643-3230.BCD-21-0203