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Management of cytokine release syndrome and macrophage activation syndrome following CAR-T cell therapy: Guidelines from the SFGM-TC

Tudesq, Jean-Jacques ; Yakoub-Agha, Mathilde ; Bay, Jacques-Olivier ; Courbon, Corinne ; Paul, Franciane ; Picard, Muriel ; Pochon, Cécile ; Sterin, Arthur ; Vicente, Céline ; Canet, Emmanuel ; Yakoub-Agha, Ibrahim ; Moreau, Anne-Sophie

Bulletin du cancer, 2023-02, Vol.110 (2S), p.S116 [Periódico revisado por pares]

France

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Título:
Management of cytokine release syndrome and macrophage activation syndrome following CAR-T cell therapy: Guidelines from the SFGM-TC
Autor: Tudesq, Jean-Jacques ; Yakoub-Agha, Mathilde ; Bay, Jacques-Olivier ; Courbon, Corinne ; Paul, Franciane ; Picard, Muriel ; Pochon, Cécile ; Sterin, Arthur ; Vicente, Céline ; Canet, Emmanuel ; Yakoub-Agha, Ibrahim ; Moreau, Anne-Sophie
Assuntos: Adrenal Cortex Hormones - therapeutic use ; Cell- and Tissue-Based Therapy ; Cytokine Release Syndrome - drug therapy ; Cytokine Release Syndrome - therapy ; Humans ; Immunotherapy, Adoptive - adverse effects ; Macrophage Activation Syndrome - complications ; Macrophage Activation Syndrome - therapy ; Neoplasm Recurrence, Local - drug therapy ; Receptors, Chimeric Antigen - therapeutic use
É parte de: Bulletin du cancer, 2023-02, Vol.110 (2S), p.S116
Descrição: The use of chimeric antigen receptor T cells (CAR-T) has increased since their approval in the treatment of several relapsed/refractory B cell malignancies. The management of their specific toxicities, such as cytokine release syndrome (CRS), tends to be better understood and well-defined. During the twelfth edition of practice harmonization workshops of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC), a working group focused its work on the management of patients developing CRS following CAR-T cell therapy. A special chapter has been allocated to macrophage activation syndrome (MAS), a rare but life-threatening complication post-CAR-T. In addition to symptomatic measures and preemptive broad-spectrum antibiotics, immunomodulators such as tocilizumab and corticosteroids remain the corner stone for the treatment of CRS. Tocilizumab/corticosteroids-resistant CRS associated with haemophagocytosis markers (spleen and liver enlargement, hyperferritinaemia>10,000ng/mL, hypofibrinogenemia…) should direct the diagnosis towards an overlapping CRS/MAS. An adapted treatment will be based on high-dose IV anakinra and corticosteroids and chemotherapy with etoposide at late refractory stages. These complications and others delignate the need of close collaboration with an intensive care unit.
Editor: France
Idioma: Francês

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Management of cytokine release syndrome and macrophage activation syndrome following CAR-T cell therapy: Guidelines from the SFGM-TC

Tudesq, Jean-Jacques ; Yakoub-Agha, Mathilde ; Bay, Jacques-Olivier ; Courbon, Corinne ; Paul, Franciane ; Picard, Muriel ; Pochon, Cécile ; Sterin, Arthur ; Vicente, Céline ; Canet, Emmanuel ; Yakoub-Agha, Ibrahim ; Moreau, Anne-Sophie

France

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