Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple Myeloma
Although chimeric antigen receptor T (CAR-T) cell therapy has proven to be effective in treating relapsed or refractory multiple myeloma (R/R MM), the severity of cytokine release syndrome (CRS) can affect patient survival and the risk factors for CRS remain an intractable issue. We enrolled 54 pati...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.814548/full |
| _version_ | 1828349587651297280 |
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| author | Xue Wang Lina Zhao Jing Wang Yue Yao Jiaojiao Wang Shengwei Ji Tian Hua Shiyuan Wang Hai Cheng Ming Shi Zhenyu Li Lingyu Zeng Junnian Zheng Kailin Xu Jiang Cao |
| author_facet | Xue Wang Lina Zhao Jing Wang Yue Yao Jiaojiao Wang Shengwei Ji Tian Hua Shiyuan Wang Hai Cheng Ming Shi Zhenyu Li Lingyu Zeng Junnian Zheng Kailin Xu Jiang Cao |
| author_sort | Xue Wang |
| collection | DOAJ |
| description | Although chimeric antigen receptor T (CAR-T) cell therapy has proven to be effective in treating relapsed or refractory multiple myeloma (R/R MM), the severity of cytokine release syndrome (CRS) can affect patient survival and the risk factors for CRS remain an intractable issue. We enrolled 54 patients with R/R MM following combined infusion of anti-CD19 and anti-B-cell maturation antigen (BCMA) CAR-T cells. The results showed the overall response rate was 94% (51/54) after CAR-T cell infusion, with a 100% incidence of CRS, including 47 patients with grade 1-2 (mild) CRS and 7 patients with grade 3-5 (severe) CRS. In the mild CRS group, the median progression-free survival (PFS) was 18.2 months (95% CI, 6.5 to 30.1) and the median overall survival (OS) was not reached yet. In the severe CRS group, median PFS and median OS were 1.9 months (95% CI, 0.2 to 3.8). Further analysis demonstrated that severe CRS had a shorter median PFS and OS than mild CRS (p=0.029, p=0.020). Bone marrow tumor burden was found to be independently associated with CRS. The grade of CRS was positively correlated with six serum cytokines levels including G-CSF, IL-6, IL-8, IP-10, MIP-1a and RANTES. In conclusion, early detection and management of CRS are imperative for the prevention of life-threatening complications and improvement in the survival of patients of CAR-T cell therapy.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR-OIC-17011272. |
| first_indexed | 2024-04-14T01:12:47Z |
| format | Article |
| id | doaj.art-10c6f399939c42febba29933acb8d58a |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-14T01:12:47Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-10c6f399939c42febba29933acb8d58a2022-12-22T02:20:58ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-04-011310.3389/fimmu.2022.814548814548Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple MyelomaXue Wang0Lina Zhao1Jing Wang2Yue Yao3Jiaojiao Wang4Shengwei Ji5Tian Hua6Shiyuan Wang7Hai Cheng8Ming Shi9Zhenyu Li10Lingyu Zeng11Junnian Zheng12Kailin Xu13Jiang Cao14Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaThe First Clinical Medical College, Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaCancer Institute, Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaJiangsu Bone Marrow Stem Cell Institute, Xuzhou, ChinaCancer Institute, Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaAlthough chimeric antigen receptor T (CAR-T) cell therapy has proven to be effective in treating relapsed or refractory multiple myeloma (R/R MM), the severity of cytokine release syndrome (CRS) can affect patient survival and the risk factors for CRS remain an intractable issue. We enrolled 54 patients with R/R MM following combined infusion of anti-CD19 and anti-B-cell maturation antigen (BCMA) CAR-T cells. The results showed the overall response rate was 94% (51/54) after CAR-T cell infusion, with a 100% incidence of CRS, including 47 patients with grade 1-2 (mild) CRS and 7 patients with grade 3-5 (severe) CRS. In the mild CRS group, the median progression-free survival (PFS) was 18.2 months (95% CI, 6.5 to 30.1) and the median overall survival (OS) was not reached yet. In the severe CRS group, median PFS and median OS were 1.9 months (95% CI, 0.2 to 3.8). Further analysis demonstrated that severe CRS had a shorter median PFS and OS than mild CRS (p=0.029, p=0.020). Bone marrow tumor burden was found to be independently associated with CRS. The grade of CRS was positively correlated with six serum cytokines levels including G-CSF, IL-6, IL-8, IP-10, MIP-1a and RANTES. In conclusion, early detection and management of CRS are imperative for the prevention of life-threatening complications and improvement in the survival of patients of CAR-T cell therapy.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR-OIC-17011272.https://www.frontiersin.org/articles/10.3389/fimmu.2022.814548/fullmultiple myelomacytokine release syndromechimeric antigen receptor T cellCD19B cell maturation antigen |
| spellingShingle | Xue Wang Lina Zhao Jing Wang Yue Yao Jiaojiao Wang Shengwei Ji Tian Hua Shiyuan Wang Hai Cheng Ming Shi Zhenyu Li Lingyu Zeng Junnian Zheng Kailin Xu Jiang Cao Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple Myeloma Frontiers in Immunology multiple myeloma cytokine release syndrome chimeric antigen receptor T cell CD19 B cell maturation antigen |
| title | Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple Myeloma |
| title_full | Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple Myeloma |
| title_fullStr | Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple Myeloma |
| title_full_unstemmed | Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple Myeloma |
| title_short | Correlation of Cytokine Release Syndrome With Prognosis After Chimeric Antigen Receptor T Cell Therapy: Analysis of 54 Patients With Relapsed or Refractory Multiple Myeloma |
| title_sort | correlation of cytokine release syndrome with prognosis after chimeric antigen receptor t cell therapy analysis of 54 patients with relapsed or refractory multiple myeloma |
| topic | multiple myeloma cytokine release syndrome chimeric antigen receptor T cell CD19 B cell maturation antigen |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.814548/full |
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