噬血细胞性淋巴组织细胞增多症
医学
弥漫性大B细胞淋巴瘤
淋巴瘤
细胞因子释放综合征
耐火材料(行星科学)
内科学
巨噬细胞活化综合征
嵌合抗原受体
免疫失调
免疫学
免疫系统
T细胞
肿瘤科
儿科
生物
关节炎
疾病
天体生物学
作者
Dong Won Kim,Ali Bukhari,Forat Lutfi,Facundo Zafforoni,Fikru Merechi,Muhamad Ali,David Gottlieb,Seung T. Lee,Mehmet H. Kocoglu,Nancy M. Hardy,Jean A. Yared,Aaron P. Rapoport,Saurabh Dahiya,Jennie Y. Law
标识
DOI:10.1080/10428194.2021.2024817
摘要
Secondary hemophagocytic lymphohistiocytosis (HLH) is a life-threatening immune dysregulation disorder. Use of chimeric antigen receptor T-cell therapy (CAR-T) is associated with cytokine release syndrome (CRS), Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS) and secondary HLH. However, application of HLH scoring systems (H-score, HLH-2004 criteria) are not validated in this setting. We analyzed the utility of applying the H-score and the HLH-2004 criteria to identify patients with possible HLH post-CAR-T for Relapsed/Refractory Diffuse Large B-cell Lymphoma. Only two of four patients with post CAR-T HLH met five or more of the diagnostic criteria for HLH by HLH 2004 criteria. In contrast all four post CAR-T HLH patients had a high H-score (>169); however, an additional ten patients that did not have HLH also had a high H-score. Thus, in this patient population, both scoring systems were demonstrated to have low prognostic significance in differentiating between high grade CRS and HLH.
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