2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma

Adoptive cellular immunotherapy with chimeric antigen receptor (CAR) T cells has emerged as a novel modality for treating relapsed and/or refractory B-cell non-Hodgkin lymphoma (B-NHL). With increasing approval of CAR T-cell products and advances in CAR T cell therapy, CAR T cells are expected to be...

Full description

Bibliographic Details
Main Authors: Ping Li, Yang Liu, Yun Liang, Jian Bo, Sujun Gao, Yongxian Hu, Yu Hu, He Huang, Xiaojun Huang, Hongmei Jing, Xiaoyan Ke, Jianyong Li, Yuhua Li, Qifa Liu, Peihua Lu, Heng Mei, Ting Niu, Yongping Song, Yuqin Song, Liping Su, Sanfang Tu, Jianxiang Wang, Depei Wu, Zhao Wang, Kailin Xu, Zhitao Ying, Qingming Yang, Yajing Zhang, Fengxia Shi, Bin Zhang, Huilai Zhang, Xi Zhang, Mingfeng Zhao, Weili Zhao, Xiangyu Zhao, Liang Huang, Jun Zhu, Wenbin Qian, Weidong Han, Aibin Liang
Format: Article
Language:English
Published: China Anti-Cancer Association 2023-02-01
Series:Cancer Biology & Medicine
Subjects:
Online Access:https://www.cancerbiomed.org/content/20/2/129
_version_ 1811161502320689152
author Ping Li
Yang Liu
Yun Liang
Jian Bo
Sujun Gao
Yongxian Hu
Yu Hu
He Huang
Xiaojun Huang
Hongmei Jing
Xiaoyan Ke
Jianyong Li
Yuhua Li
Qifa Liu
Peihua Lu
Heng Mei
Ting Niu
Yongping Song
Yuqin Song
Liping Su
Sanfang Tu
Jianxiang Wang
Depei Wu
Zhao Wang
Kailin Xu
Zhitao Ying
Qingming Yang
Yajing Zhang
Fengxia Shi
Bin Zhang
Huilai Zhang
Xi Zhang
Mingfeng Zhao
Weili Zhao
Xiangyu Zhao
Liang Huang
Jun Zhu
Wenbin Qian
Weidong Han
Aibin Liang
author_facet Ping Li
Yang Liu
Yun Liang
Jian Bo
Sujun Gao
Yongxian Hu
Yu Hu
He Huang
Xiaojun Huang
Hongmei Jing
Xiaoyan Ke
Jianyong Li
Yuhua Li
Qifa Liu
Peihua Lu
Heng Mei
Ting Niu
Yongping Song
Yuqin Song
Liping Su
Sanfang Tu
Jianxiang Wang
Depei Wu
Zhao Wang
Kailin Xu
Zhitao Ying
Qingming Yang
Yajing Zhang
Fengxia Shi
Bin Zhang
Huilai Zhang
Xi Zhang
Mingfeng Zhao
Weili Zhao
Xiangyu Zhao
Liang Huang
Jun Zhu
Wenbin Qian
Weidong Han
Aibin Liang
author_sort Ping Li
collection DOAJ
description Adoptive cellular immunotherapy with chimeric antigen receptor (CAR) T cells has emerged as a novel modality for treating relapsed and/or refractory B-cell non-Hodgkin lymphoma (B-NHL). With increasing approval of CAR T-cell products and advances in CAR T cell therapy, CAR T cells are expected to be used in a growing number of cases. However, CAR T-cell-associated toxicities can be severe or even fatal, thus compromising the survival benefit from this therapy. Standardizing and studying the clinical management of these toxicities are imperative. In contrast to other hematological malignancies, such as acute lymphoblastic leukemia and multiple myeloma, anti-CD19 CAR T-cell-associated toxicities in B-NHL have several distinctive features, most notably local cytokine-release syndrome (CRS). However, previously published guidelines have provided few specific recommendations for the grading and management of toxicities associated with CAR T-cell treatment for B-NHL. Consequently, we developed this consensus for the prevention, recognition, and management of these toxicities, on the basis of published literature regarding the management of anti-CD19 CAR T-cell-associated toxicities and the clinical experience of multiple Chinese institutions. This consensus refines a grading system and classification of CRS in B-NHL and corresponding measures for CRS management, and delineates comprehensive principles and exploratory recommendations for managing anti-CD19 CAR T-cell-associated toxicities in addition to CRS.
first_indexed 2024-04-10T06:15:21Z
format Article
id doaj.art-9444c9c2b3e5428698211ae089d3471a
institution Directory Open Access Journal
issn 2095-3941
language English
last_indexed 2024-04-10T06:15:21Z
publishDate 2023-02-01
publisher China Anti-Cancer Association
record_format Article
series Cancer Biology & Medicine
spelling doaj.art-9444c9c2b3e5428698211ae089d3471a2023-03-02T08:55:42ZengChina Anti-Cancer AssociationCancer Biology & Medicine2095-39412023-02-0120212914610.20892/j.issn.2095-3941.2022.05852022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphomaPing Li0Yang Liu1Yun Liang2Jian Bo3Sujun Gao4Yongxian Hu5Yu Hu6He Huang7Xiaojun Huang8Hongmei Jing9Xiaoyan Ke10Jianyong Li11Yuhua Li12Qifa Liu13Peihua Lu14Heng Mei15Ting Niu16Yongping Song17Yuqin Song18Liping Su19Sanfang Tu20Jianxiang Wang21Depei Wu22Zhao Wang23Kailin Xu24Zhitao Ying25Qingming Yang26Yajing Zhang27Fengxia Shi28Bin Zhang29Huilai Zhang30Xi Zhang31Mingfeng Zhao32Weili Zhao33Xiangyu Zhao34Liang Huang35Jun Zhu36Wenbin Qian37Weidong Han38Aibin Liang39Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, ChinaDepartment of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, ChinaDepartment of Hematology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Hematology, The First Hospital of Jilin University, Changchun 130012, ChinaCenter for Bone Marrow Transplantation, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, ChinaInstitute of Hematology, Union Hospital of Tongji Medical College; Huazhong University of Science and Technology, Wuhan 430022, ChinaCenter for Bone Marrow Transplantation, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, ChinaPeking University People’s Hospital & Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, ChinaDepartment of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, ChinaDepartment of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, ChinaDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaLu Daopei Institute of Hematology, Beijing 101102, ChinaInstitute of Hematology, Union Hospital of Tongji Medical College; Huazhong University of Science and Technology, Wuhan 430022, ChinaDepartment of Hematology, West China Hospital, Sichuan University, Chengdu 610041, ChinaThe Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, ChinaDepartment of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing 100142, ChinaDepartment of Hematology, Shanxi Cancer Hospital, Taiyuan 030013, ChinaDepartment of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Division of Pediatric Blood Disease Center, Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, ChinaDepartment of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, ChinaDepartment of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, ChinaDepartment of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing 100142, ChinaDepartment of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, ChinaInstitute of Blood and Marrow Transplantation, The Fifth Medical Center, Chinese PLA General Hospital, Beijing 100039, ChinaDepartment of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, ChinaMedical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing 400037, ChinaDepartment of Hematology, Tianjin First Central Hospital, Tianjin 300192, ChinaDepartment of Hematology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaPeking University People’s Hospital & Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, ChinaDepartment of Hematology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, ChinaDepartment of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing 100142, ChinaDepartment of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, ChinaDepartment of Bio-therapeutic, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, ChinaAdoptive cellular immunotherapy with chimeric antigen receptor (CAR) T cells has emerged as a novel modality for treating relapsed and/or refractory B-cell non-Hodgkin lymphoma (B-NHL). With increasing approval of CAR T-cell products and advances in CAR T cell therapy, CAR T cells are expected to be used in a growing number of cases. However, CAR T-cell-associated toxicities can be severe or even fatal, thus compromising the survival benefit from this therapy. Standardizing and studying the clinical management of these toxicities are imperative. In contrast to other hematological malignancies, such as acute lymphoblastic leukemia and multiple myeloma, anti-CD19 CAR T-cell-associated toxicities in B-NHL have several distinctive features, most notably local cytokine-release syndrome (CRS). However, previously published guidelines have provided few specific recommendations for the grading and management of toxicities associated with CAR T-cell treatment for B-NHL. Consequently, we developed this consensus for the prevention, recognition, and management of these toxicities, on the basis of published literature regarding the management of anti-CD19 CAR T-cell-associated toxicities and the clinical experience of multiple Chinese institutions. This consensus refines a grading system and classification of CRS in B-NHL and corresponding measures for CRS management, and delineates comprehensive principles and exploratory recommendations for managing anti-CD19 CAR T-cell-associated toxicities in addition to CRS.https://www.cancerbiomed.org/content/20/2/129car t-cell therapyb-cell non-hodgkin lymphomatoxicitycytokine-release syndromeclinical management
spellingShingle Ping Li
Yang Liu
Yun Liang
Jian Bo
Sujun Gao
Yongxian Hu
Yu Hu
He Huang
Xiaojun Huang
Hongmei Jing
Xiaoyan Ke
Jianyong Li
Yuhua Li
Qifa Liu
Peihua Lu
Heng Mei
Ting Niu
Yongping Song
Yuqin Song
Liping Su
Sanfang Tu
Jianxiang Wang
Depei Wu
Zhao Wang
Kailin Xu
Zhitao Ying
Qingming Yang
Yajing Zhang
Fengxia Shi
Bin Zhang
Huilai Zhang
Xi Zhang
Mingfeng Zhao
Weili Zhao
Xiangyu Zhao
Liang Huang
Jun Zhu
Wenbin Qian
Weidong Han
Aibin Liang
2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma
Cancer Biology & Medicine
car t-cell therapy
b-cell non-hodgkin lymphoma
toxicity
cytokine-release syndrome
clinical management
title 2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma
title_full 2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma
title_fullStr 2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma
title_full_unstemmed 2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma
title_short 2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma
title_sort 2022 chinese expert consensus and guidelines on clinical management of toxicity in anti cd19 chimeric antigen receptor t cell therapy for b cell non hodgkin lymphoma
topic car t-cell therapy
b-cell non-hodgkin lymphoma
toxicity
cytokine-release syndrome
clinical management
url https://www.cancerbiomed.org/content/20/2/129
work_keys_str_mv AT pingli 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yangliu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yunliang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT jianbo 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT sujungao 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yongxianhu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yuhu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT hehuang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT xiaojunhuang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT hongmeijing 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT xiaoyanke 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT jianyongli 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yuhuali 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT qifaliu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT peihualu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT hengmei 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT tingniu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yongpingsong 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yuqinsong 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT lipingsu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT sanfangtu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT jianxiangwang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT depeiwu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT zhaowang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT kailinxu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT zhitaoying 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT qingmingyang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT yajingzhang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT fengxiashi 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT binzhang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT huilaizhang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT xizhang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT mingfengzhao 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT weilizhao 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT xiangyuzhao 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT lianghuang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT junzhu 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT wenbinqian 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT weidonghan 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma
AT aibinliang 2022chineseexpertconsensusandguidelinesonclinicalmanagementoftoxicityinanticd19chimericantigenreceptortcelltherapyforbcellnonhodgkinlymphoma