Using JAK inhibitor to treat cytokine release syndrome developed after chimeric antigen receptor T cell therapy for patients with refractory acute lymphoblastic leukemia: A case report

Significant concerns about the adverse effects following chimeric antigen receptor T cell (CAR-T) therapy are still remained including cytokine release syndrome (CRS). In rare circumstances, CRS may be refractory to tocilizumab and/or corticosteroids, a new treatment is needed for the management of...

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Bibliographic Details
Published in:Medicine (Baltimore) 2021-05, Vol.100 (19), p.e25786-e25786
Main Authors: Zi, Fu Ming, Ye, Long Long, Zheng, Ji Fu, Cheng, Jing, Wang, Qing Ming
Format: Article
Language:English
Subjects:
Clinical Case Report
Cytokine Release Syndrome - drug therapy
Cytokine Release Syndrome - etiology
Humans
Immunotherapy, Adoptive - adverse effects
Immunotherapy, Adoptive - methods
Janus Kinase Inhibitors - therapeutic use
Male
Nitriles
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Pyrazoles - therapeutic use
Pyrimidines
Receptors, Chimeric Antigen - therapeutic use
Young Adult
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Summary:Significant concerns about the adverse effects following chimeric antigen receptor T cell (CAR-T) therapy are still remained including cytokine release syndrome (CRS). In rare circumstances, CRS may be refractory to tocilizumab and/or corticosteroids, a new treatment is needed for the management of CRS. We present a case of a 20-year-old male patient with acute lymphoblastic leukemia developed CRS after CD19/CD22 bispecific CAR-T treatment. The patient was diagnosed with BCR-ABL(P210) positive B-ALL and developed CRS after CD19/CD22 bispecific CAR-T treatment. Tocilizumab and methylprednisolone were administered, unfortunately the patient's symptoms of CRS were still not resolved. Another methylprednisolone and ruxolitinib were administered. The persistent fever and hypotension of this patient achieved a rapid clinical remission within hours after ruxolitinib administration. Ruxolitinib can be used as an alternative therapeutic approach for severe and refractory CRS without impairing CAR-T amplification and anti-tumor effect.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000025786