摘要
Chimeric antigen receptor T(CAR T)cell therapy has demonstrated efficacy in the treatment of haematologic malignancies.However,the accompanying adverse events,the most common of which is cytokine release syndrome(CRS),substantially limit its wide application.Due to its unique physiological characteristics,CRS in CAR T-cell treatment for B-cell non-Hodgkin lymphoma(BNHL)may exhibit some special features.Although existing guidelines had greatly promoted the recognition and management of CRS,many recommendations are not fully applicable to B-NHL.Therefore,it is imperative to identify responses that are specific to CRS observed following CAR T treatment for B-NHL.Based on underlying biological processes and known pathophysiological mechanisms,we tentatively propose a new model to illustrate the occurrence and evolution of CAR T-cell-therapy-related CRS in BNHL.In this model,tumour burden and bone marrow suppression are considered determinants of CRS.Novel phenomena after CAR T-cell infusion(such as local inflammatory response)are further identified.The proposed model will help us better understand the basic biology of CRS and recognize and manage it more rationally.
基金
supported by grants from the National Natural Science Foundation of China(No.81830002 and 31991171 to W.D.H.,No.81703044 to J.S.W.,No.81830006 to W.B.Q.and No.8183004 to A.B.L.)
a Leading Talents Grant of Science&Technology from Beijing(No.Z181100006318004 to W.D.H.)
a grant from the Science Technology Department of Zhejiang Province(No.2018C03016-1 to W.B.Q.).