# Effect of early tocilizumab intervention on patients with cytokine release syndrome following chimeric antigen receptor T cell therapy

## TL;DR

Early use of tocilizumab reduces severe cytokine release syndrome in CAR-T therapy for leukemia without increasing risks.

## Contribution

Demonstrates that early tocilizumab intervention improves outcomes in CAR-T-treated ALL patients with cytokine release syndrome.

## Key findings

- Early tocilizumab use prevented CRS-related deaths and did not increase neurotoxicity.
- Early intervention group had a higher complete remission rate with minimal residual disease negativity.
- Median event-free survival was longer in the early intervention group compared to the conventional group.

## Abstract

分析早期使用托珠单抗缓解细胞因子释放综合征（CRS）对嵌合抗原受体T细胞（CAR-T细胞）治疗效果的影响。

收集2015 年10月至2021年7月同济大学附属同济医院血液科输注靶向CD19 CAR-T细胞后发生CRS并接受托珠单抗治疗的22例急性淋巴细胞白血病（ALL）患者资料。按照托珠单抗干预的时机分为常规组和早期干预组，患者持续高热4 h即接受托珠单抗治疗的为早期干预组。回顾性分析两组之间的临床资料、CRS分级和无事件生存。

与发生了严重CRS后常规使用托珠单抗相比，早期干预组没有患者因CRS死亡，没有增加神经毒性风险。11例（84.62％）患者获得微小残留病阴性的完全缓解。常规组和早期干预组的中位无事件生存时间分别为2（95％CI 0～5）个月、7（95％CI 3～11）个月。

早期使用托珠单抗干预患者的CRS有助于减少重症CRS的发生，并为CAR-T细胞治疗ALL产生的CRS反应提供了更优化的治疗策略。