Hemophagocytic Lymphohistiocytosis-like Toxicity (carHLH) after CD19-specific CAR T-Cell Therapy
| Autor: | Aimee C Talleur, Camille Keenan, Stephen Gottschalk, Gabriela Maria Marón Alfaro, Melissa Hines, Brandon M. Triplett, Cheng Cheng, Akshay Sharma, Kim E. Nichols, Caitlin Hurley, Yinmei Zhou |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Antigens CD19 Gastroenterology Immunotherapy Adoptive CD19 Article Lymphohistiocytosis Hemophagocytic Young Adult Internal medicine medicine Humans Immunologic Factors Young adult Child Hemophagocytic lymphohistiocytosis biology business.industry Hematology medicine.disease Survival Analysis Chimeric antigen receptor Cytokine release syndrome Child Preschool Toxicity biology.protein CAR T-cell therapy Chimeric Antigen Receptor T-Cell Therapy Female business |
| Zdroj: | Br J Haematol |
| Popis: | Chimeric antigen receptor T-cell (CAR T-cell) therapy is associated with significant toxicities secondary to immune activation, including a rare but increasingly recognised severe toxicity resembling haemophagocytic lymphohistiocytosis (carHLH). We report the development of carHLH in 14·8% of paediatric patients and young adults treated with CD19-specific CAR T-cell therapy with carHLH, occurring most commonly in those with high disease burden. The diagnosis and treatment of carHLH required a high index of suspicion and included multidrug immunomodulation with variable response to therapies. Compared to patients without carHLH, patients with carHLH had both reduced response to CAR T-cell therapy (P-value = 0·018) and overall survival (P-value = < 0·0001). |
| Databáze: | OpenAIRE |
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