Incidence, Risk Factors, and Impact on Transplant Outcomes of Cytokine Release Syndrome After Infusion of Haploidentical Stem Cells With Anti-Thymocyte Globulin
Feng-Mei Zheng
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorJun Kong
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorJing-Zhi Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorZhi-Dong Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorFeng-Rong Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorTing-Ting Han
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorHai-Xia Fu
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorWei Han
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYuan-Yuan Zhang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorChen-Hua Yan
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorHuan Chen
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYao Chen
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYu-Hong Chen
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorXiao-Dong Mo
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorMeng Lv
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYu-Qian Sun
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYi-Fei Cheng
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorLan-Ping Xu
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorXiao-Hui Zhang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorKai-Yan Liu
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorXiao-Jun Huang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
Search for more papers by this authorCorresponding Author
Yu Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorFeng-Mei Zheng
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorJun Kong
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorJing-Zhi Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorZhi-Dong Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorFeng-Rong Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorTing-Ting Han
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorHai-Xia Fu
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorWei Han
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYuan-Yuan Zhang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorChen-Hua Yan
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorHuan Chen
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYao Chen
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYu-Hong Chen
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorXiao-Dong Mo
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorMeng Lv
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYu-Qian Sun
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorYi-Fei Cheng
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorLan-Ping Xu
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorXiao-Hui Zhang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorKai-Yan Liu
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorXiao-Jun Huang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
Search for more papers by this authorCorresponding Author
Yu Wang
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China
Search for more papers by this authorFunding: This work was supported by the National Key Research and Development Program of China (No. 2023YFC2508905; 2022YFA1103300), the National Natural Science Foundation of China (82470214; 82270227; 82070189), the Key Program of the National Natural Science Foundation of China (No. 81930004), the Major Program of the National Natural Science Foundation of China (No. 82293630), and Peking University Medicine Fund for World's Leading Discipline or Discipline Cluster Development (No. 71003Y3035).
ABSTRACT
Background
Cytokine release syndrome (CRS) after graft infusion under anti-thymocyte globulin (ATG)–based haploidentical (haplo)-hematopoietic stem cell transplantation is unclear.
Objective
The purpose of this study was to explore the clinical implications of CRS after graft infusion under ATG-based haplo-SCT.
Study Design
We retrospectively analyzed the data of 259 patients who underwent haplo-SCT, graded CRS, and evaluated transplant outcomes.
Results
CRS occurred in 103/259 (39.8%) of the recipients. Severe CRS (Grades 3–5) was not observed. Fever was the most common manifestation (89.3%), and all cases occurred only after peripheral blood stem cell (PBSC) infusion. According to the multivariable analysis, being older than 55 years (OR 2.486 (1.124–5.496), p = 0.024), having higher CRP levels during conditioning (OR 3.011 (95% CI, 1.766–5.134), p < 0.001), and receiving PBSC as the sole stem cell source (OR 2.478 (95% CI, 1.077–5.700), p = 0.033) could predict the development of CRS, whereas an HCT-CI score ≥ 2 was an independent risk factor for Grade 2 CRS (OR 4.259 (95% CI, 1.515–11.969, p = 0.006)). The 3-year OS was not significantly different between the two groups, with 79% (95% CI, 61–97) for Grade 2 CRS and 85% (95% CI, 80–90) for Grade 0–1 CRS (p = 0.288). The GRFS rates in the two groups were 69% (95% CI, 49–90) and 67% (95% CI, 60–74), respectively (p = 0.644).
Conclusion
Our results suggest that CRS is common in patients receiving ATG-based haplo-SCT and does not affect survival.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| ctr70242-sup-0001-tableS1.xlsx11.1 KB | Supplementary Table 1. Grading system of cytokine release syndrome. |
| ctr70242-sup-0002-figureS1.tiff1.3 MB | Supplementary Figure 1. Cumulative incidence of relapse according to cytokine release syndrome (CRS) grade. |
| ctr70242-sup-0003-figureS2.tiff1.3 MB | Supplementary Figure 2. Rate of disease-free survival (DFS) according to cytokine release syndrome (CRS) grade. |
| ctr70242-sup-0004-figureS3.tiff1.3 MB | Supplementary Figure 3. Rate of graft-versus-host disease-free, relapse-free survival (GRFS) according to cytokine release syndrome (CRS) grade. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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