Pleural cavity cytokine release syndrome in CD19-directed chimeric antigen receptor-modified T cell therapy

Pleural cavity cytokine release syndrome in CD19-directed chimeric antigen receptor-modified T... AbstractRationale:Cytokine release syndrome (CRS) is a common and potentially fatal complication of CAR-T cell therapy. However, compartment CRS is relatively rare in hematological malignancies, as well as in solid tumors. The pathogenesis and prognosis of compartment CRS are unclear and there is no standardized treatment yet. In this case report, we will introduce a patient developing pleural cavity CRS after CART19s infusion.Patient concerns:A 28-year-old woman was admitted for evaluation of mediastinal mass. Her relevant examinations were comoleted.Diagnoses:She was diagnosed as diffuse large B cell lymphoma (DLBCL, non-GCB type).Interventions:She received chemotherapies including 1 cycle of R-DAEPORCH, 1 cycle of R-CHOPE, 2 cycles of R-CHOP, and 4 cycles of R-GDP during the disease course.Outcomes:The cytokine levels of hydrothorax were considerably high when serum cytokines were within normal range, with IL-6 at 1212.45 versus 5.69 pg/mL. qPCR analysis for CAR constructs showed 1,119,696 copies/μg DNA in hydrothorax and 522,227 copies/μg DNA in blood.Lessons:The results indicated that CART19 cells trafficked to the pleural cavity and interacted with the CD19-positive lymphoma cells directly, causing cytokine release in situ. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Medicine Wolters Kluwer Health

Pleural cavity cytokine release syndrome in CD19-directed chimeric antigen receptor-modified T cell therapy

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Publisher
Wolters Kluwer
Copyright
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.
ISSN
0025-7974
eISSN
1536-5964
D.O.I.
10.1097/MD.0000000000009992
Publisher site
See Article on Publisher Site

Abstract

AbstractRationale:Cytokine release syndrome (CRS) is a common and potentially fatal complication of CAR-T cell therapy. However, compartment CRS is relatively rare in hematological malignancies, as well as in solid tumors. The pathogenesis and prognosis of compartment CRS are unclear and there is no standardized treatment yet. In this case report, we will introduce a patient developing pleural cavity CRS after CART19s infusion.Patient concerns:A 28-year-old woman was admitted for evaluation of mediastinal mass. Her relevant examinations were comoleted.Diagnoses:She was diagnosed as diffuse large B cell lymphoma (DLBCL, non-GCB type).Interventions:She received chemotherapies including 1 cycle of R-DAEPORCH, 1 cycle of R-CHOPE, 2 cycles of R-CHOP, and 4 cycles of R-GDP during the disease course.Outcomes:The cytokine levels of hydrothorax were considerably high when serum cytokines were within normal range, with IL-6 at 1212.45 versus 5.69 pg/mL. qPCR analysis for CAR constructs showed 1,119,696 copies/μg DNA in hydrothorax and 522,227 copies/μg DNA in blood.Lessons:The results indicated that CART19 cells trafficked to the pleural cavity and interacted with the CD19-positive lymphoma cells directly, causing cytokine release in situ.

Journal

MedicineWolters Kluwer Health

Published: Feb 1, 2018

References

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