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Cytokine release syndrome and relevant factors of CD19 targeted chimeric antigen receptor T cell therapy in relapsed/refractory B cell hematological malignancies

  • Author Footnotes
    1 These authors have contributed equally to this work and share first authorship.
    Qian-wen Xu
    Footnotes
    1 These authors have contributed equally to this work and share first authorship.
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Author Footnotes
    1 These authors have contributed equally to this work and share first authorship.
    Hui Xu
    Footnotes
    1 These authors have contributed equally to this work and share first authorship.
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to this work and share first authorship.
    Lei Xue
    Footnotes
    1 These authors have contributed equally to this work and share first authorship.
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
    Search for articles by this author
  • Li Wang
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Xu-han Zhang
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Kai-di Song
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Wen Yao
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Xiang Wan
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Juan Tong
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Hui-lan Liu
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Xin Liu
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Xiao-yu Zhu
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Zi-min Sun
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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  • Xing-bing Wang
    Correspondence
    Correspondence to: Department of Hematology, The First Affiliated Hospital of USTC, 17 Lujiang Road, Hefei, Anhui, China.
    Affiliations
    Department of Hematology, The First Affiliated Hospital of USCT (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to this work and share first authorship.

      Abstract

      Objectives and methods

      We reviewed the outcomes of 77 episodes of CD19 CAR-T therapy in 67 patients with B cell hematological malignancies from October 2016 to January 2020. Factors related to the grade of cytokine release syndrome (CRS) were explored by multivariate analysis, nonparametric test was conducted to explore the correlation between CRS and response. Kaplan–Meier curves were used to indicate survival profiles, and the correlation between CRS and survival was determined by the log-rank test.

      Results

      The rate of complete remission (CR) was 74.0% (57/77). CRS of any grade occurred in 68 of 77 episodes (grade 1: 32.5%, grade 2: 24.7%, grade 3: 22.1%, grade 4: 6.5%, grade 5: 2.6%). Patients with a history of transplantation had less severe CRS, and dose escalation-based infusion reduced the severity of CRS. Severe CRS was related to a higher CR rate but had no significant impact on event-free survival (EFS), relapse-free survival (RFS), or overall survival (OS).

      Conclusion

      As a common adverse reaction of CAR-T therapy, the severity of CRS can be alleviated by dose escalation infusion, a history of transplantation was correlated with less severe CRS. Severe CRS was related to better response but was unrelated to long-term survival.

      Keywords

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