TY - JOUR
T1 - Current concepts in the diagnosis and management of cytokine release syndrome
AU - Lee, Daniel W.
AU - Gardner, Rebecca
AU - Porter, David L.
AU - Louis, Chrystal U.
AU - Ahmed, Nabil
AU - Jensen, Michael
AU - Grupp, Stephan A.
AU - Mackall, Crystal L.
PY - 2014/7/10
Y1 - 2014/7/10
N2 - As immune-based therapies for cancer become potent, more effective, and more widely available, optimal management of their unique toxicities becomes increasinglyimportant. Cytokinereleasesyndrome (CRS) is a potentially life-threatening toxicity that has been observed following administration of natural and bispecific antibodies and, more recently, following adoptive T-cell therapies for cancer. CRS is associated with elevated circulating levels of several cytokines including interleukin (IL)-6 and interferon γ, and uncontrolled studies demonstrate that immunosuppression using tocilizumab, an anti-IL-6 receptor antibody, with or without corticosteroids, can reverse the syndrome. However, because early and aggressive immunosuppression could limit the efficacy of the immunotherapy, current approaches seek to limit administration of immunosuppressive therapy to patients at risk for life-threatening consequences of the syndrome. This report presents a novel system to grade the severity of CRS in individual patients and a treatment algorithm for management of CRS based on severity. The goal of our approach is to maximize the chance for therapeutic benefit from the immunotherapy while minimizing the risk for life threatening complications of CRS.
AB - As immune-based therapies for cancer become potent, more effective, and more widely available, optimal management of their unique toxicities becomes increasinglyimportant. Cytokinereleasesyndrome (CRS) is a potentially life-threatening toxicity that has been observed following administration of natural and bispecific antibodies and, more recently, following adoptive T-cell therapies for cancer. CRS is associated with elevated circulating levels of several cytokines including interleukin (IL)-6 and interferon γ, and uncontrolled studies demonstrate that immunosuppression using tocilizumab, an anti-IL-6 receptor antibody, with or without corticosteroids, can reverse the syndrome. However, because early and aggressive immunosuppression could limit the efficacy of the immunotherapy, current approaches seek to limit administration of immunosuppressive therapy to patients at risk for life-threatening consequences of the syndrome. This report presents a novel system to grade the severity of CRS in individual patients and a treatment algorithm for management of CRS based on severity. The goal of our approach is to maximize the chance for therapeutic benefit from the immunotherapy while minimizing the risk for life threatening complications of CRS.
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U2 - 10.1182/blood-2014-05-552729
DO - 10.1182/blood-2014-05-552729
M3 - Article
C2 - 24876563
AN - SCOPUS:84904097189
SN - 0006-4971
VL - 124
SP - 188
EP - 195
JO - Blood
JF - Blood
IS - 2
ER -