ASBMT Consensus Grading for Cytokine Release Syndrome and Neurological Toxicity Associated with Immune Effector Cells
By Daniel W. Lee, B. Santomasso, F. Locke, A. Ghobadi, C. Turtle, Jennifer N. Brudno, M. Maus, Jae H. Park, E. Mead, S. Pavletic and 12 more. Biology of Blood and Marrow Transplantation, 2018
3,090 citations recorded by the source corpus.
Chimeric antigen receptor (CAR) T cell therapy is rapidly emerging as one of the most promising therapies for hematological malignancies. Two CAR T products were recently approved in the United States and Europe for the treatment of patients with relapsed or refractory B-cell acute lymphoblastic leukemia up to the age of 25 years and/or adults with large B-cell lymphoma. Many more CAR T products as well as other immunotherapies including various immune cell- and bi-specific antibody-based approaches that function by activation of immune effector cells are in clinical development for both hematologic and solid tumor malignancies. These therapies are associated with unique toxicities of cytokine release syndrome (CRS) and neurological toxicity. The assessment and grading of these toxicities have varied considerably across clinical trials and across institutions, making it difficult to compare safety of different products and hindering the ability to develop optimal strategies for management of these toxicities. Moreover, some aspects of these grading systems can be challenging to implement widely across centers. Therefore, in an effort to harmonize the definitions and grading systems for CRS and neurotoxicity, experts from all aspects of the field met on June 20–21, 2018, at a meeting supported by the American Society for Blood and Marrow Transplantation (ASBMT) in Arlington, VA. Here, we report the consensus of the group and propose new definitions and grading for CRS and neurotoxicity that are objective, easy to use, and ultimately more accurately categorize the severity of these toxicities. The goal is to provide a uniform consensus grading system for CRS and neurotoxicity associated with immune effector cell therapies, for use across clinical trials and in the post-approval clinical setting.
Subfields: Genetics, Oncology, Physiology
View Paper: https://www.semanticscholar.org/paper/7db97470115ff856f1893f6ed4850df9d0e57b5a
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Citations in the corpus
- Standard-of-Care Axicabtagene Ciloleucel for Relapsed or Refractory Large B-Cell Lymphoma: Results From the US Lymphoma CAR T Consortium. (2020, methodology): “the inception of ZUMA-1, with themajority of patients in our study graded using a more sensitive CARTOX grading system,(12) which was recently modified into the American Society for Transplantation and Cellular Therapy consensus grading system for neurotoxicity now referred to as immune effector cel”
- Engineering strategies to overcome the current roadblocks in CAR T cell therapy (2019, background): “Accordingly, IL-1 receptor antagonists, either administered systemically or secreted from engineered CAR T cells, ameliorate CRS and neurotoxicity in mouse models of leukaemia or lymphoma treated with anti-CD19 CAR T cells 71,72 .”