Zhongguo shi yan xue ye xue za zhi · 2024
[Fever Characteristics and Biomarker Changes of CRS in Patients with Relapsed/Refractory Multiple Myeloma after CAR-T Cell Therapy].
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Hua Tian, Wang Jiao-Jiao, Ji Sheng-Wei, Liu Jia-Ying, Chen Zi-Han, Shao Ling-Yan, Cheng Hai, Cao Jiang
Аннотация
OBJECTIVE: To investigate the correlation of the clinical characteristics, fever characteristics, serum biomarkers with cytokine release syndrome (CRS) in patients with relapsed/refractory multiple myeloma (R/R MM) treated with chimeric antigen receptor T cell (CAR-T) immunotherapy.
METHODS: 104 R/R MM patients who received CAR-T cell therapy at the Affiliated Hospital of Xuzhou Medical University from June 2017 to November 2021 were included, and the correlations of their clinical characteristics, fever characteristics, serum biomarkers with the severity of CRS were analyzed.
RESULTS: Among 104 R/R MM patients receiving CAR-T treatment, no CRS was observed in 8 cases (7.7%), and 96 cases (92.3%) developed CRS. Patients with high-risk cytogenetics had a higher risk of developing CRS (P =0.040), while patients who had previously received autologous hematopoietic stem cell transplantation (ASCT) had a lower risk of developing CRS (P =0.004). There was a significant difference in the duration of fever between patients with grade 1-2 and grade 3-5 CRS (P =0.006). The highest body temperature varied among patients with different treatment regimens (P =0.001). The decrease in total protein in patients with CRS was more significant than in patients without CRS (P =0.002). Within one month after CAR-T cell infusion, the degree of albumin recovery in patients with grade 3-5 CRS was lower than that in patients with grade 0-2 CRS (P =0.037). Compared to patients with grade 1-2 CRS, patients with grade 3-5 CRS showed a significant increase in heart rate after CAR-T cell infusion (P =0.013), while IL-6, C-reactive protein (CRP), and serum ferritin (SF) also showed significant increases (P =0.007, P < 0.001, P =0.003).
CONCLUSION: High-risk cytogenetics is a risk factor for severe CRS. Long duration of fever is a clinical characteristic of severe CRS. CRP can better reflect the severity of CRS.
METHODS: 104 R/R MM patients who received CAR-T cell therapy at the Affiliated Hospital of Xuzhou Medical University from June 2017 to November 2021 were included, and the correlations of their clinical characteristics, fever characteristics, serum biomarkers with the severity of CRS were analyzed.
RESULTS: Among 104 R/R MM patients receiving CAR-T treatment, no CRS was observed in 8 cases (7.7%), and 96 cases (92.3%) developed CRS. Patients with high-risk cytogenetics had a higher risk of developing CRS (P =0.040), while patients who had previously received autologous hematopoietic stem cell transplantation (ASCT) had a lower risk of developing CRS (P =0.004). There was a significant difference in the duration of fever between patients with grade 1-2 and grade 3-5 CRS (P =0.006). The highest body temperature varied among patients with different treatment regimens (P =0.001). The decrease in total protein in patients with CRS was more significant than in patients without CRS (P =0.002). Within one month after CAR-T cell infusion, the degree of albumin recovery in patients with grade 3-5 CRS was lower than that in patients with grade 0-2 CRS (P =0.037). Compared to patients with grade 1-2 CRS, patients with grade 3-5 CRS showed a significant increase in heart rate after CAR-T cell infusion (P =0.013), while IL-6, C-reactive protein (CRP), and serum ferritin (SF) also showed significant increases (P =0.007, P < 0.001, P =0.003).
CONCLUSION: High-risk cytogenetics is a risk factor for severe CRS. Long duration of fever is a clinical characteristic of severe CRS. CRP can better reflect the severity of CRS.