Prophylactic Tocilizumab Prior to Anti-CD19 CAR-T Cell Therapy for Non-Hodgkin Lymphoma

Simple item page
dc.contributor.authorCaimi, Paolo F.
dc.contributor.authorPacheco Sanchez, Gabriela
dc.contributor.authorSharma, Ashish
dc.contributor.authorOtegbeye, Folashade
dc.contributor.authorAhmed, Nausheen
dc.contributor.authorRojas, Patricio
dc.contributor.authorPatel, Seema
dc.contributor.authorKleinsorge Block, Sarah
dc.contributor.authorSchiavone, Jennifer
dc.contributor.authorZamborsky, Kayla
dc.contributor.authorBoughan, Kirsten
dc.contributor.authorHillian, Antoinette
dc.contributor.authorReese-Koc, Jane
dc.contributor.authorMaschan, Mikhail
dc.contributor.authorDropulic, Boro
dc.contributor.authorSekaly, Rafick-Pierre
dc.contributor.authorDe Lima, Marcos
dc.date.accessioned2025-01-20T22:05:42Z
dc.date.available2025-01-20T22:05:42Z
dc.date.issued2021
dc.description.abstractAnti-CD19 chimeric antigen receptor T (CAR-T) cells have demonstrated activity against relapsed/refractory lymphomas. Cytokine release syndrome (CRS) and immune effector cell - associated neurotoxicity syndrome (ICANS) are well-known complications. Tocilizumab, a monoclonal antibody targeting the interleukin-6 (IL-6) receptor was administered 1 hour prior to infusion of anti-CD19 CAR-T cells with CD3 zeta/4-1BB costimulatory signaling used to treat non-Hodgkin lymphoma patients. Relapsed/refractory lymphoma patients treated with anti-CD19 CAR-T cells were included in this analysis. Cytokine plasma levels were measured by electrochemiluminescence before lymphodepleting chemotherapy, prior to infusion and then on days 2, 4,6, and 14 days after treatment. Twenty patients were treated. Cell products included locally manufactured anti-CD19 CAR-T (n=18) and tisagenlecleucel (n=2). There were no adverse events attributed to tocilizumab. Ten patients had grade 1-2 CRS at a median of 4 (range 3-7) days. There were no cases of grade >= 3 CRS. Five patients had ICANS, grade 1 (n=4) and grade 4 (n=1). Laboratory studies obtained prior to lymphodepleting chemotherapy were comparable between patients with and without CRS, except for interleukin (IL)-15 plasma concentrations. patients with CRS had higher post-infusion ferritin and C reactive protein, with more marked increases in inflammatory cytokines, including IL-6, IL-15, IFN-gamma, fractalkine and MCP-1. Fifteen patients (75%) achieved CR and 2 (10%), PR. One-year OS and PFS estimates were 83% and 73%. Prophylactic tocilizumab was associated with low CRS incidence and severity. There were no adverse events associated with tocilizumab, no increase in frequency or severity of ICANS and excellent disease control and overall survival.</p>
dc.fuente.origenWOS
dc.identifier.doi10.3389/fimmu.2021.745320
dc.identifier.issn1664-3224
dc.identifier.urihttps://doi.org/10.3389/fimmu.2021.745320
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94161
dc.identifier.wosidWOS:000713443000001
dc.language.isoen
dc.revistaFrontiers in immunology
dc.rightsacceso restringido
dc.subjecttocilizumab
dc.subjectCAR- T cells
dc.subjectlymphoma
dc.subjectprophylaxis
dc.subjectcytokine release syndrome (CRS)
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleProphylactic Tocilizumab Prior to Anti-CD19 CAR-T Cell Therapy for Non-Hodgkin Lymphoma
dc.typeartículo
dc.volumen12
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
Files
Collections
Artículos de revistas