Hemophagocytic lymphohistiocytosis‐like toxicity (carHLH) after CD19‐specific CAR T‐cell therapy. (15th July 2021)

• Record Type: Journal Article
• Authors: Hines, Melissa R.; Keenan, Camille; Maron Alfaro, Gabriela; Cheng, Cheng; Zhou, Yinmei; Sharma, Akshay; Hurley, Caitlin; Nichols, Kim E.; Gottschalk, Stephen; Triplett, Brandon M.; Talleur, Aimee C.
• Is Part Of: British journal of haematology. Volume 194:Number 4(2021)
• Page Start: 701
• Page End: 707
• Publication Date: 2021-07-15
• Subjects: chimeric antigen receptor T‐cell therapy -- refractory acute B‐cell lymphoblastic leukaemia -- haemophagocytic lymphohistiocytosis -- cytokine release syndrome; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.17662
• Languages: English
• ISSNs: 0007-1048

Abstract

Summary: Chimeric antigen receptor T‐cell (CAR T‐cell) therapy is associated with significant toxicities secondary to immune activation, including a rare but increasingly recognised severe toxicity resembling haemophagocytic lymphohistiocytosis (carHLH). We report the development of carHLH in 14·8% of paediatric patients and young adults treated with CD19‐specific CAR T‐cell therapy with carHLH, occurring most commonly in those with high disease burden. The diagnosis and treatment of carHLH required a high index of suspicion and included multidrug immunomodulation with variable response to therapies. Compared to patients without carHLH, patients with carHLH had both reduced response to CAR T‐cell therapy ( P ‐value = 0·018) and overall survival ( P ‐value = < 0·0001).