Journal of Clinical Pediatrics >
Side effects of CAR-T cell therapy in children
Received date: 2022-11-29
Online published: 2024-04-09
Chimeric antigen receptor (CAR)-T cells have become one of the most promising methods for the treatment of malignant tumors due to their specific recognition function and cytotoxicity. However, it also has a series of side effects, especially in children. Toxic reactions can develop rapidly and endanger life in severe cases. In this paper, the side effects of CAR-T cell therapy in children, as well as its clinical manifestations and treatment are summarized, aiming to optimize its application in children.
Key words： chimeric antigen receptor T cell; side effect; child
Mengmeng Reviewer: YIN , Qun Reviser: HU . Side effects of CAR-T cell therapy in children[J]. Journal of Clinical Pediatrics, 2024 , 42(4) : 361 -366 . DOI: 10.12372/jcp.2024.22e1605
| [1] | Abramson JS, Lunning M, Palomba ML. Chimeric antigen receptor T-cell therapies for aggressive B-cell lymphomas: current and future state of the art[J]. Am Soc Clin Oncol Educ Book, 2019, 39: 446-453. |
| [2] | Schubert ML, Schmitt M, Wang L, et al. Side-effect management of chimeric antigen receptor (CAR) T-cell therapy[J]. Ann Oncol, 2021, 32(1): 34-48. |
| [3] | Brown A, Gutierrez C. Comments regarding "ASBMT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells"[J]. Biol Blood Marrow Transplant, 2019, 25(6): e209-e210. |
| [4] | Frey N, Porter D. Cytokine Release Syndrome with chimeric antigen receptor T cell therapy[J]. Biol Blood Marrow Transplant, 2019, 25(4): e123-e127. |
| [5] | Yakoub-Agha I, Chabannon C, Bader P, et al. Management of adults and children undergoing chimeric antigen receptor T-cell therapy: best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE)[J]. Haematologica, 2020, 105(2): 297-316. |
| [6] | Neelapu SS, Tummala S, Kebriaei P, et al. Chimeric antigen receptor T-cell therapy - assessment and management of toxicities[J]. Nat Rev Clin Oncol, 2018, 15(1): 47-62. |
| [7] | Nair R, Westin J. CAR T-cells[J]. Adv Exp Med Biol, 2020, 1244: 215-233. |
| [8] | Chavez JC, Jain MD, Kharfan-Dabaja MA. Cytokine release syndrome and neurologic toxicities associated with chimeric antigen receptor T-cell therapy: A comprehensive review of emerging grading models[J]. Hematol Oncol Stem Cell Ther, 2020, 13(1): 1-6. |
| [9] | Strati P, Ahmed S, Kebriaei P, et al. Clinical efficacy of anakinra to mitigate CAR T-cell therapy-associated toxicity in large B-cell lymphoma[J]. Blood Adv, 2020, 4(13): 3123-3127. |
| [10] | Levine JE, Grupp SA, Pulsipher MA, et al. Pooled safety analysis of tisagenlecleucel in children and young adults with B cell acute lymphoblastic leukemia[J]. J Immunother Cancer, 2021, 9(8): e002287. |
| [11] | Torre M, Solomon IH, Sutherland CL, et al. Neuro-pathology of a case with fatal CAR T-cell-associated cerebral edema[J]. J Neuropathol Exp Neurol, 2018, 77(10): 877-882. |
| [12] | Hunter BD, Jacobson CA. CAR T-cell associated neurotoxicity: mechanisms, clinicopathologic correlates, and future directions[J]. J Natl Cancer Inst, 2019, 111(7): 646-654. |
| [13] | Gust J, Hay KA, Hanafi LA, et al. Endothelial activation and blood-brain barrier disruption in neurotoxicity after adoptive immunotherapy with CD19 CAR-T cells[J]. Cancer Discov, 2017, 7(12): 1404-1419. |
| [14] | Santomasso BD, Park JH, Salloum D, et al. Clinical and biological correlates of neurotoxicity associated with CAR T-cell therapy in patients with B-cell acute lymphoblastic leukemia[J]. Cancer Discov, 2018, 8(8): 958-971. |
| [15] | Traube C, Silver G, Kearney J, et al. Cornell assessment of pediatric delirium: a valid, rapid, observational tool for screening delirium in the PICU*[J]. Crit Care Med, 2014, 42(3): 656-663. |
| [16] | Karschnia P, Jordan JT, Forst DA, et al. Clinical presentation, management, and biomarkers of neurotoxicity after adoptive immunotherapy with CAR T cells[J]. Blood, 2019, 133(20): 2212-2221. |
| [17] | Zhou J, Zhang Y, Shan M, et al. Cytopenia after chimeric antigen receptor T cell immunotherapy in relapsed or refractory lymphoma[J]. Front Immunol, 2022, 13: 997589. |
| [18] | Logue JM, Zucchetti E, Bachmeier CA, et al. Immune reconstitution and associated infections following axicabtagene ciloleucel in relapsed or refractory large B-cell lymphoma[J]. Haematologica, 2021, 106(4): 978-986. |
| [19] | Fried S, Avigdor A, Bielorai B, et al. Early and late hematologic toxicity following CD19 CAR-T cells[J]. Bone Marrow Transplant, 2019, 54(10): 1643-1650. |
| [20] | Jain T, Knezevic A, Pennisi M, et al. Hematopoietic recovery in patients receiving chimeric antigen receptor T-cell therapy for hematologic malignancies[J]. Blood Adv, 2020, 4(15): 3776-3787. |
| [21] | Schubert ML, Dietrich S, Stilgenbauer S, et al. Feasibility and safety of CD19 chimeric antigen receptor T cell treatment for B cell lymphoma relapse after allogeneic hematopoietic stem cell transplantation[J]. Biol Blood Marrow Transplant, 2020, 26(9): 1575-1580. |
| [22] | Doan A, Pulsipher MA. Hypogammaglobulinemia due to CAR T-cell therapy[J]. Pediatr Blood Cancer, 2018, 65(4): 10.1002/pbc.26914. |
| [23] | Mahmoudjafari Z, Hawks KG, Hsieh AA, et al. American Society for Blood and Marrow Transplantation Pharmacy Special Interest Group survey on chimeric antigen receptor T cell therapy administrative, logistic, and toxicity management practices in the United States[J]. Biol Blood Marrow Transplant, 2019, 25(1): 26-33. |
| [24] | Hill JA, Li D, Hay KA, et al. Infectious complications of CD19-targeted chimeric antigen receptor-modified T-cell immunotherapy[J]. Blood, 2018, 131(1): 121-130. |
| [25] | Los-Arcos I, Iacoboni G, Aguilar-Guisado M, et al. Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper[J]. Infection, 2021, 49(2): 215-231. |
| [26] | Strati P, Nastoupil LJ, Fayad LE, et al. Safety of CAR T-cell therapy in patients with B-cell lymphoma and chronic hepatitis B or C virus infection[J]. Blood, 2019, 133(26): 2800-2802. |
| [27] | Hwang JP, Torres HA. Hepatitis B virus and hepatitis C virus infection in immunocompromised patients[J]. Curr Opin Infect Dis, 2018, 31(6): 535-541. |
| [28] | Hill J A, Seo SK. How I prevent infections in patients receiving CD19-targeted chimeric antigen receptor T cells for B-cell malignancies[J]. Blood, 2020, 136(8): 925-935. |
| [29] | Dai CY, Chuang WL, Yu ML. EASL recommendations on treatment of hepatitis C: Final update of the series-Some issues[J]. J Hepatol, 2021, 74(2): 473-474. |
| [30] | Hiwarkar P, Kosulin K, Cesaro S, et al. Management of adenovirus infection in patients after haematopoietic stem cell transplantation: State-of-the-art and real-life current approach: a position statement on behalf of the Infectious Diseases Working Party of the European Society of Blood and Marrow Transplantation[J]. Rev Med Virol, 2018, 28(3): e1980. |
| [31] | Marty FM, Winston DJ, Chemaly RF, et al. A randomized, double-blind, placebo-controlled phase 3 trial of oral brincidofovir for cytomegalovirus prophylaxis in allogeneic hematopoietic cell transplantation[J]. Biol Blood Marrow Transplant, 2019, 25(2): 369-381. |
| [32] | Vena A, Bouza E, Alvarez-Uria A, et al. The misleading effect of serum galactomannan testing in high-risk haematology patients receiving prophylaxis with micafungin[J]. Clin Microbiol Infect, 2017, 23(12): 1000-1001. |
| [33] | Howard SC, Trifilio S, Gregory TK, et al. Tumor lysis syndrome in the era of novel and targeted agents in patients with hematologic malignancies: a systematic review[J]. Ann Hematol, 2016, 95(4): 563-573. |
| [34] | Guha A, Addison D, Jain P, et al. Cardiovascular events associated with chimeric antigen receptor T cell therapy: cross-sectional FDA adverse events reporting system analysis[J]. Biol Blood Marrow Transplant, 2020, 26(12): 2211-2216. |
| [35] | Burstein DS, Maude S, Grupp S, et al. Cardiac profile of chimeric antigen receptor T cell therapy in children: a single-institution experience[J]. Biol Blood Marrow Transplant, 2018, 24(8): 1590-1595. |
| [36] | Denton CC, Gange WS, Abdel-Azim H, et al. Bilateral retinal detachment after chimeric antigen receptor T-cell therapy[J]. Blood Adv, 2020, 4(10): 2158-2162. |
| [37] | Gupta S, Seethapathy H, Strohbehn IA, et al. Acute kidney injury and electrolyte abnormalities after chimeric antigen receptor T-Cell (CAR-T) therapy for diffuse large B-cell lymphoma[J]. Am J Kidney Dis, 2020, 76(1): 63-71. |
| [38] | Shah NN, Highfill SL, Shalabi H, et al. CD4/CD8 T-cell selection affects chimeric antigen receptor (CAR) T-cell potency and toxicity: updated results from a phase I anti-CD22 CAR T-cell trial[J]. J Clin Oncol, 2020, 38(17): 1938-1950. |
| [39] | Lee DW, Santomasso BD, Locke FL, et al. ASTCT consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells[J]. Biol Blood Marrow Transplant, 2019, 25(4): 625-638. |
| [40] | Hashmi H, Bachmeier C, Chavez JC, et al. Haemo-phagocytic lymphohistiocytosis has variable time to onset following CD19 chimeric antigen receptor T cell therapy[J]. Br J Haematol, 2019, 187(2): e35-e38. |
| [41] | Canna SW, Marsh RA. Pediatric hemophagocytic lymphohistiocytosis[J]. Blood, 2020, 135(16): 1332-1343. |
| [42] | Cruz CR, Hanley PJ, Liu H, et al. Adverse events following infusion of T cells for adoptive immunotherapy: a 10-year experience[J]. Cytotherapy, 2010, 12(6): 743-749. |
| [43] | Shah NN, Qin H, Yates B, et al. Clonal expansion of CAR T cells harboring lentivector integration in the CBL gene following anti-CD22 CAR T-cell therapy[J]. Blood Adv, 2019, 3(15): 2317-2322. |
| [44] | Wolfl M, Rasche M, Eyrich M, et al. Spontaneous reversion of a lineage switch following an initial blinatumomab-induced ALL-to-AML switch in MLL-rearranged infant ALL[J]. Blood Adv, 2018, 2(12): 1382-1385. |
| [45] | Good ML, Malekzadeh P, Kriley IR, et al. Intrahepatic cholangiocarcinoma as a rare secondary malignancy after allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia: A case report[J]. Pediatr Transplant, 2020, 24(2): e13653. |
| [46] | Steineck A, Wiener L, Mack JW, et al. Psychosocial care for children receiving chimeric antigen receptor (CAR) T-cell therapy[J]. Pediatr Blood Cancer, 2020, 67(5): e28249. |
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