Cytokine Release Syndrome With the Novel Treatments of Acute Lymphoblastic Leukemia: Pathophysiology, Prevention, and Treatment
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Purpose of Review
T cell-based therapies (blinatumomab and CAR T cell therapy) have produced unprecedented responses in relapsed and refractory (r/r) acute lymphoblastic leukemia (ALL) but is accompanied with significant toxicities, of which one of the most common and serious is cytokine release syndrome (CRS). Here we will review the pathophysiology, prevention, and treatment of CRS.
Efforts have been initiated to define and grade cytokine release syndrome (CRS), to identify patients at risk, to describe biomarkers that predict onset and severity, to understand the pathophysiology, and to prevent and treat severe cases to reduce T cell immunotherapy-related morbidity and mortality.
Optimizing the timing of T cell-based therapies in ALL, identifying new biomarkers, and investigating novel anti-cytokine agents that have anti-CRS activity are likely to be fruitful avenues of study.
KeywordsAcute lymphoblastic leukemia Cytokine release syndrome Chimeric antigen receptor T cell therapy Immunotherapy Blinatumomab
Compliance with Ethical Standards
Conflict of Interest
Ibrahim Aldoss declares that he has no conflict of interest.
Samer K. Khaled has received compensation from Juno Therapeutics for service as a consultant.
Elizabeth Budde declares that she has no conflict of interest.
Anthony S. Stein has received compensation from Amgen and Celgene for service on speakers’ bureaus.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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