Here we report the consensus recommendations of that group and propose new definitions and grading for CRS and neurotoxicity that are objective, easy to apply, and ultimately more accurately categorize the severity of these toxicities.

2018年11月10日 · Here we report the consensus recommendations of that group and propose new definitions and grading for CRS and neurotoxicity that are objective, easy to apply, and ultimately more accurately categorize the severity of these toxicities.

ASTCT Definition of CRS CRS is “a supraphysiologic response following any immune therapy that results in the activation or engagement of endogenous or infused T cells and/or other immune effector cells. Symptoms can be progressive, must include fever at the onset and may include hypotension, capillary leak (hypoxia) and end organ dysfunction.”

2020年4月9日 · Regrading of CRS from the JULIET trial using the Penn, Lee, and ASTCT systems highlights the need for standardized CRS grading practices. Chimeric antigen receptor T-cell (CAR-T) therapy yields durable responses in patients with relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL).

Chimeric antigen receptor (CAR) T cell therapy is rapidly emerging as one of the most promising therapies for hemato-logic malignancies.

Cytokine release syndrome (CRS) is a potential serious toxicity of any immune therapy that engages endogenous or infused T-cells. It is especially associated with adoptive cellular therapies such as chimeric antigen receptor T-cell (CAR-T) therapy.

For patient with early fever (within 72 hrs) or signiicant comorbidities can consider early tocilizumab. Tocilizumab 8 mg/kg (Consider alternative agents after 2 doses) *No more than 3 doses in a 24 hr period or 4 doses in total. Dexamethasone (10 mg q12-24 hrs) with tocilizumab initial tocilizumab.

High-dose anakinra (up to 12 mg/kg/day) for refractory cytokine release syndrome (CRS)/immune effector cell-associated neurotoxicity syndrome (ICANS) was safe. Higher anakinra dose may be associated with faster CRS/ICANS resolution and was independently associated with lower treatment-related mortality.

Here we report the consensus recommendations of that group and propose new definitions and grading for CRS and neurotoxicity that are objective, easy to apply, and ultimately more accurately categorize the severity of these toxicities.

ASTCT = American Society for Transplantation and Cellular Therapy; BiPAP = bilevel positive airway pressure; CPAP = continuous positive airway pressure; CRS = cytokine release syndrome; CTCAE = Common Terminology Criteria for Adverse Events.