Экстракорпоральная сорбция цитокинов при синдроме высвобождения цитокинов у больного острым лимфобластным лейкозом после терапии T-клетками с химерным антигенным рецептором. Клиническое наблюдение.
Экстракорпоральная сорбция цитокинов при синдроме высвобождения цитокинов у больного острым лимфобластным лейкозом после терапии T-клетками с химерным антигенным рецептором. Клиническое наблюдение.
Щекина А.Е., Галстян Г.М., Гаврилина О.А., Арапова Н.М., Бронякина С.Ю., Котова Е.С., Троицкая В.В., Паровичникова Е.Н., Масчан М.А., Савченко В.Г. Экстракорпоральная сорбция цитокинов при синдроме высвобождения цитокинов у больного острым лимфобластным лейкозом после терапии T-клетками с химерным антигенным рецептором. Клиническое наблюдение. Терапевтический архив. 2021; 93 (7): 811–817. DOI: 10.26442/00403660.2021.07.200931
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Аннотация
Распространенным осложнением терапии T-клетками с химерным антигенным рецептором (CAR-T-терапии) является синдром высвобождения цитокинов (СВЦ). Представлено клиническое наблюдение за больным В-острым лимфобластным лейкозом, у которого после CAR-T-терапии развился СВЦ, протекавший с шоком и полиорганной недостаточностью, что потребовало применения сорбции цитокинов в сочетании с гемодиафильтрацией и позволило вывести больного из шока и привести к разрешению СВЦ. В результате CAR-T-терапии достигнута ремиссия лейкоза.
Ключевые слова: CAR-T-терапия, синдром высвобождения цитокинов, сорбция цитокинов
Keywords: CAR-T-cell therapy, cytokine release syndrome, cytokine adsorption
Ключевые слова: CAR-T-терапия, синдром высвобождения цитокинов, сорбция цитокинов
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Keywords: CAR-T-cell therapy, cytokine release syndrome, cytokine adsorption
Список литературы
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3. Gutierrefz C, Brown ART, Herr MM, et al. The chimeric antigen receptor-intensive care unit (CAR-ICU) initiative: Surveying intensive care unit practices in the management of CAR T-cell associated toxicities. J Crit Care. 2020;58:58-64. DOI:10.1016/j.jcrc.2020.04.008
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16. Dai H, Wu Z, Jia H, et al. Bispecific CAR-T cells targeting both CD19 and CD22 for therapy of adults with relapsed or refractory B cell acute lymphoblastic leukemia. J Hematol Oncol. 2020;13(1):30. DOI:10.1186/s13045-020-00856-8
17. Gupta S, Seethapathy H, Strohbehn IA, et al. Acute Kidney Injury and Electrolyte Abnormalities After Chimeric Antigen Receptor T-Cell (CAR-T) Therapy for Diffuse Large B-Cell Lymphoma. Am J Kidney Dis. 2020;76(1):63-71. DOI:10.1053/j.ajkd.2019.10.011
18. Davila ML, Riviere I, Wang X, et al. Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia. Sci Transl Med. 2014;6(224):224ra45. DOI:10.1126/scitranslmed.3008226
19. Liu S, Deng B, Yin Z, et al. Corticosteroids do not influence the efficacy and kinetics of CAR-T cells for B-cell acute lymphoblastic leukemia. Blood Cancer J. 2020;10(2):15. DOI:10.1038/s41408-020-0280-y
20. Ankawi G, Xie Y, Yang B, et al. What Have We Learned about the Use of Cytosorb Adsorption Columns? Blood Purif. 2019;48(3):196-202. DOI:10.1159/000500013
21. Kogelmann K, Jarczak D, Scheller M, et al. Hemoadsorption by CytoSorb in septic patients: A case series. Crit Care. 2017;21(1):74. DOI:10.1186/s13054-017-1662-9
2. Maude SL, Laetsch TW, Buechner J, et al. Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia. N Engl J Med. 2018;378(5):439-48. DOI:10.1056/nejmoa1709866
3. Gutierrefz C, Brown ART, Herr MM, et al. The chimeric antigen receptor-intensive care unit (CAR-ICU) initiative: Surveying intensive care unit practices in the management of CAR T-cell associated toxicities. J Crit Care. 2020;58:58-64. DOI:10.1016/j.jcrc.2020.04.008
4. Lee DW, Santomasso BD, Locke FL, et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood and Marrow Transplant. 2019;25(4):625-38. DOI:10.1016/j.bbmt.2018.12.758
5. Si S, Teachey DT. Spotlight on tocilizumab in the treatment of car-t-cell-induced cytokine release syndrome. Ther Clin Risk Manag. 2020;16:705‑14. DOI:10.2147/TCRM.S223468
6. Bottari G, Merli P, Guzzo I, et al. Multimodal Therapeutic Approach of Cytokine Release Syndrome Developing in a Child Given Chimeric Antigen Receptor-Modified T Cell Infusion. Crit Care Explor. 2020;2(1):e0071. DOI:10.1097/cce.0000000000000071
7. Stahl K, Schmidt BMW, Hoeper MM, et al. Extracorporeal cytokine removal in severe CAR-T cell associated cytokine release syndrome. J Crit Care. 2020;57:124-9. DOI:10.1016/j.jcrc.2020.02.010
8. Schädler D, Pausch C, Heise D, et al. The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. Plos ONE. 2017;12(10):e018715. DOI:10.1371/journal.pone.0187015
9. Magomedov MA, Kim TG, Masolitin SV, et al. Use of sorbent based on hypercrosslinked styrene-divinylbenzene copolymer with immobilized LPS-selective ligand in hemoperfusion for treatment of patients with septic shock. Obshchaya Reanimatologiya. 2021;16(6):31-53. DOI:10.15360/1813-9779-2020-6-31-53
10. Bernardi MH, Rinoesl H, Dragosits K, et al. Effect of hemoadsorption during cardiopulmonary bypass surgery – a blinded, randomized, controlled pilot study using a novel adsorbent. Crit Care. 2016;20(1):96. DOI:10.1186/s13054-016-1270-0
11. Al Shareef K, Bakouri M. Cytokine Blood Filtration Responses in COVID-19. Blood Purif. 2020;50(2):141-9. DOI:10.1159/000508278
12. Azoulay E, Shimabukuro-Vornhagen A, Darmon M, et al. Critical care management of chimeric antigen receptor T cell-related toxicity be aware and prepared. Am J Respir Crit Care Med. 2019;200(1):20-3. DOI:10.1164/rccm.201810-1945ED
13. Azoulay E, Castro P, Maamar A, et al. Critical Care Management of CAR-T Cell Recipients: The CARTTAS International Study. Lancet Haematol. 2021;8(5):e355-64. DOI:10.1016/S2352-3026(21)00060-0
14. Gutierrez C, McEvoy C, Mead E, et al. Management of the critically ill adult chimeric antigen receptor-t cell therapy patient: A critical care perspective. Crit Care Med. 2018;46(9):1402-10. DOI:10.1097/CCM.0000000000003258
15. Neelapu SS, Locke FL, Bartlett NL, et al. Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-Cell lymphoma. N Engl J Med. 2017;377(26):2531-44. DOI:10.1056/NEJMoa1707447
16. Dai H, Wu Z, Jia H, et al. Bispecific CAR-T cells targeting both CD19 and CD22 for therapy of adults with relapsed or refractory B cell acute lymphoblastic leukemia. J Hematol Oncol. 2020;13(1):30. DOI:10.1186/s13045-020-00856-8
17. Gupta S, Seethapathy H, Strohbehn IA, et al. Acute Kidney Injury and Electrolyte Abnormalities After Chimeric Antigen Receptor T-Cell (CAR-T) Therapy for Diffuse Large B-Cell Lymphoma. Am J Kidney Dis. 2020;76(1):63-71. DOI:10.1053/j.ajkd.2019.10.011
18. Davila ML, Riviere I, Wang X, et al. Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia. Sci Transl Med. 2014;6(224):224ra45. DOI:10.1126/scitranslmed.3008226
19. Liu S, Deng B, Yin Z, et al. Corticosteroids do not influence the efficacy and kinetics of CAR-T cells for B-cell acute lymphoblastic leukemia. Blood Cancer J. 2020;10(2):15. DOI:10.1038/s41408-020-0280-y
20. Ankawi G, Xie Y, Yang B, et al. What Have We Learned about the Use of Cytosorb Adsorption Columns? Blood Purif. 2019;48(3):196-202. DOI:10.1159/000500013
21. Kogelmann K, Jarczak D, Scheller M, et al. Hemoadsorption by CytoSorb in septic patients: A case series. Crit Care. 2017;21(1):74. DOI:10.1186/s13054-017-1662-9
2. Maude SL, Laetsch TW, Buechner J, et al. Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia. N Engl J Med. 2018;378(5):439-48. DOI:10.1056/nejmoa1709866
3. Gutierrefz C, Brown ART, Herr MM, et al. The chimeric antigen receptor-intensive care unit (CAR-ICU) initiative: Surveying intensive care unit practices in the management of CAR T-cell associated toxicities. J Crit Care. 2020;58:58-64. DOI:10.1016/j.jcrc.2020.04.008
4. Lee DW, Santomasso BD, Locke FL, et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood and Marrow Transplant. 2019;25(4):625-38. DOI:10.1016/j.bbmt.2018.12.758
5. Si S, Teachey DT. Spotlight on tocilizumab in the treatment of car-t-cell-induced cytokine release syndrome. Ther Clin Risk Manag. 2020;16:705‑14. DOI:10.2147/TCRM.S223468
6. Bottari G, Merli P, Guzzo I, et al. Multimodal Therapeutic Approach of Cytokine Release Syndrome Developing in a Child Given Chimeric Antigen Receptor-Modified T Cell Infusion. Crit Care Explor. 2020;2(1):e0071. DOI:10.1097/cce.0000000000000071
7. Stahl K, Schmidt BMW, Hoeper MM, et al. Extracorporeal cytokine removal in severe CAR-T cell associated cytokine release syndrome. J Crit Care. 2020;57:124-9. DOI:10.1016/j.jcrc.2020.02.010
8. Schädler D, Pausch C, Heise D, et al. The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. Plos ONE. 2017;12(10):e018715. DOI:10.1371/journal.pone.0187015
9. Magomedov MA, Kim TG, Masolitin SV, et al. Use of sorbent based on hypercrosslinked styrene-divinylbenzene copolymer with immobilized LPS-selective ligand in hemoperfusion for treatment of patients with septic shock. Obshchaya Reanimatologiya. 2021;16(6):31-53. DOI:10.15360/1813-9779-2020-6-31-53
10. Bernardi MH, Rinoesl H, Dragosits K, et al. Effect of hemoadsorption during cardiopulmonary bypass surgery – a blinded, randomized, controlled pilot study using a novel adsorbent. Crit Care. 2016;20(1):96. DOI:10.1186/s13054-016-1270-0
11. Al Shareef K, Bakouri M. Cytokine Blood Filtration Responses in COVID-19. Blood Purif. 2020;50(2):141-9. DOI:10.1159/000508278
12. Azoulay E, Shimabukuro-Vornhagen A, Darmon M, et al. Critical care management of chimeric antigen receptor T cell-related toxicity be aware and prepared. Am J Respir Crit Care Med. 2019;200(1):20-3. DOI:10.1164/rccm.201810-1945ED
13. Azoulay E, Castro P, Maamar A, et al. Critical Care Management of CAR-T Cell Recipients: The CARTTAS International Study. Lancet Haematol. 2021;8(5):e355-64. DOI:10.1016/S2352-3026(21)00060-0
14. Gutierrez C, McEvoy C, Mead E, et al. Management of the critically ill adult chimeric antigen receptor-t cell therapy patient: A critical care perspective. Crit Care Med. 2018;46(9):1402-10. DOI:10.1097/CCM.0000000000003258
15. Neelapu SS, Locke FL, Bartlett NL, et al. Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-Cell lymphoma. N Engl J Med. 2017;377(26):2531-44. DOI:10.1056/NEJMoa1707447
16. Dai H, Wu Z, Jia H, et al. Bispecific CAR-T cells targeting both CD19 and CD22 for therapy of adults with relapsed or refractory B cell acute lymphoblastic leukemia. J Hematol Oncol. 2020;13(1):30. DOI:10.1186/s13045-020-00856-8
17. Gupta S, Seethapathy H, Strohbehn IA, et al. Acute Kidney Injury and Electrolyte Abnormalities After Chimeric Antigen Receptor T-Cell (CAR-T) Therapy for Diffuse Large B-Cell Lymphoma. Am J Kidney Dis. 2020;76(1):63-71. DOI:10.1053/j.ajkd.2019.10.011
18. Davila ML, Riviere I, Wang X, et al. Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia. Sci Transl Med. 2014;6(224):224ra45. DOI:10.1126/scitranslmed.3008226
19. Liu S, Deng B, Yin Z, et al. Corticosteroids do not influence the efficacy and kinetics of CAR-T cells for B-cell acute lymphoblastic leukemia. Blood Cancer J. 2020;10(2):15. DOI:10.1038/s41408-020-0280-y
20. Ankawi G, Xie Y, Yang B, et al. What Have We Learned about the Use of Cytosorb Adsorption Columns? Blood Purif. 2019;48(3):196-202. DOI:10.1159/000500013
21. Kogelmann K, Jarczak D, Scheller M, et al. Hemoadsorption by CytoSorb in septic patients: A case series. Crit Care. 2017;21(1):74. DOI:10.1186/s13054-017-1662-9
________________________________________________
2. Maude SL, Laetsch TW, Buechner J, et al. Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia. N Engl J Med. 2018;378(5):439-48. DOI:10.1056/nejmoa1709866
3. Gutierrefz C, Brown ART, Herr MM, et al. The chimeric antigen receptor-intensive care unit (CAR-ICU) initiative: Surveying intensive care unit practices in the management of CAR T-cell associated toxicities. J Crit Care. 2020;58:58-64. DOI:10.1016/j.jcrc.2020.04.008
4. Lee DW, Santomasso BD, Locke FL, et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood and Marrow Transplant. 2019;25(4):625-38. DOI:10.1016/j.bbmt.2018.12.758
5. Si S, Teachey DT. Spotlight on tocilizumab in the treatment of car-t-cell-induced cytokine release syndrome. Ther Clin Risk Manag. 2020;16:705‑14. DOI:10.2147/TCRM.S223468
6. Bottari G, Merli P, Guzzo I, et al. Multimodal Therapeutic Approach of Cytokine Release Syndrome Developing in a Child Given Chimeric Antigen Receptor-Modified T Cell Infusion. Crit Care Explor. 2020;2(1):e0071. DOI:10.1097/cce.0000000000000071
7. Stahl K, Schmidt BMW, Hoeper MM, et al. Extracorporeal cytokine removal in severe CAR-T cell associated cytokine release syndrome. J Crit Care. 2020;57:124-9. DOI:10.1016/j.jcrc.2020.02.010
8. Schädler D, Pausch C, Heise D, et al. The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. Plos ONE. 2017;12(10):e018715. DOI:10.1371/journal.pone.0187015
9. Magomedov MA, Kim TG, Masolitin SV, et al. Use of sorbent based on hypercrosslinked styrene-divinylbenzene copolymer with immobilized LPS-selective ligand in hemoperfusion for treatment of patients with septic shock. Obshchaya Reanimatologiya. 2021;16(6):31-53. DOI:10.15360/1813-9779-2020-6-31-53
10. Bernardi MH, Rinoesl H, Dragosits K, et al. Effect of hemoadsorption during cardiopulmonary bypass surgery – a blinded, randomized, controlled pilot study using a novel adsorbent. Crit Care. 2016;20(1):96. DOI:10.1186/s13054-016-1270-0
11. Al Shareef K, Bakouri M. Cytokine Blood Filtration Responses in COVID-19. Blood Purif. 2020;50(2):141-9. DOI:10.1159/000508278
12. Azoulay E, Shimabukuro-Vornhagen A, Darmon M, et al. Critical care management of chimeric antigen receptor T cell-related toxicity be aware and prepared. Am J Respir Crit Care Med. 2019;200(1):20-3. DOI:10.1164/rccm.201810-1945ED
13. Azoulay E, Castro P, Maamar A, et al. Critical Care Management of CAR-T Cell Recipients: The CARTTAS International Study. Lancet Haematol. 2021;8(5):e355-64. DOI:10.1016/S2352-3026(21)00060-0
14. Gutierrez C, McEvoy C, Mead E, et al. Management of the critically ill adult chimeric antigen receptor-t cell therapy patient: A critical care perspective. Crit Care Med. 2018;46(9):1402-10. DOI:10.1097/CCM.0000000000003258
15. Neelapu SS, Locke FL, Bartlett NL, et al. Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-Cell lymphoma. N Engl J Med. 2017;377(26):2531-44. DOI:10.1056/NEJMoa1707447
16. Dai H, Wu Z, Jia H, et al. Bispecific CAR-T cells targeting both CD19 and CD22 for therapy of adults with relapsed or refractory B cell acute lymphoblastic leukemia. J Hematol Oncol. 2020;13(1):30. DOI:10.1186/s13045-020-00856-8
17. Gupta S, Seethapathy H, Strohbehn IA, et al. Acute Kidney Injury and Electrolyte Abnormalities After Chimeric Antigen Receptor T-Cell (CAR-T) Therapy for Diffuse Large B-Cell Lymphoma. Am J Kidney Dis. 2020;76(1):63-71. DOI:10.1053/j.ajkd.2019.10.011
18. Davila ML, Riviere I, Wang X, et al. Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia. Sci Transl Med. 2014;6(224):224ra45. DOI:10.1126/scitranslmed.3008226
19. Liu S, Deng B, Yin Z, et al. Corticosteroids do not influence the efficacy and kinetics of CAR-T cells for B-cell acute lymphoblastic leukemia. Blood Cancer J. 2020;10(2):15. DOI:10.1038/s41408-020-0280-y
20. Ankawi G, Xie Y, Yang B, et al. What Have We Learned about the Use of Cytosorb Adsorption Columns? Blood Purif. 2019;48(3):196-202. DOI:10.1159/000500013
21. Kogelmann K, Jarczak D, Scheller M, et al. Hemoadsorption by CytoSorb in septic patients: A case series. Crit Care. 2017;21(1):74. DOI:10.1186/s13054-017-1662-9
Авторы
А.Е. Щекина*1, Г.М. Галстян1, О.А. Гаврилина1, Н.М. Арапова1, С.Ю. Бронякина1, Е.С. Котова1, В.В. Троицкая1, Е.Н. Паровичникова1, М.А. Масчан2, В.Г. Савченко1
1 ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России, Москва, Россия;
2 ФБГУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева», Москва, Россия
*shekina_ae@mail.ru
Svetlana Yu. Bronyakina1, Ekaterina S. Kotova1, Vera V. Troitskaya1, Elena N. Parovichnikova1, Mikhail A. Maschan2, Valerii G. Savchenko1
1 National Research Center for Hematology, Moscow, Russia;
2 Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
*shekina_ae@mail.ru
1 ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России, Москва, Россия;
2 ФБГУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева», Москва, Россия
*shekina_ae@mail.ru
________________________________________________
Svetlana Yu. Bronyakina1, Ekaterina S. Kotova1, Vera V. Troitskaya1, Elena N. Parovichnikova1, Mikhail A. Maschan2, Valerii G. Savchenko1
1 National Research Center for Hematology, Moscow, Russia;
2 Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
*shekina_ae@mail.ru
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