Could cytokine release syndrome induce acute myelofibrosis in CD19 chimeric antigen receptor T cells therapy?

Xun Lai, Yun Yan Sun, Lung Ji Chang, Yu Ru Ma, Xue Zhong Gu, Xiang Mei Yao, Bo Nie, Yan Wen, Xue Mei Zhang, Ya Xian Jiang, Hui Yang, Li Qun Yu, Ming Jing Fang, Ling Wang, Xue Yuan Bo, Xun Lai, Yun Yan Sun, Lung Ji Chang, Yu Ru Ma, Xue Zhong Gu, Xiang Mei Yao, Bo Nie, Yan Wen, Xue Mei Zhang, Ya Xian Jiang, Hui Yang, Li Qun Yu, Ming Jing Fang, Ling Wang, Xue Yuan Bo

Abstract

CAR-T cells therapy can give rise to most common and concerning two side effects - cytokine release syndrome (CRS) and neurotoxicity. But in our CD19 CAR-T cells therapy clinical trial, we observed 1 out of 17 patients with B-cell acute lymphoblastic leukemia (B-ALL) developed acute myelofibrosis(AMF) after grade IV CRS post to the CD19 CAR-T cells therapy. This finding suggests that the CAR-T cells therapy may have rare and serious AMF, which we should pay important attention to. Trial registration:NCT02968472. Registered 18 November 2016 - Retrospectively registered, https://ichgcp.net/clinical-trials-registry/NCT02968472.

Keywords: AMF; B-ALL; BMF; CAR-T; CRS.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1.
Figure 1.
Therapy and bone marrow fibrosis (BMF) diagnosis line.
Figure 2.
Figure 2.
(a-d), (h) & (e) and reticulin stain of bone marrow fibrosis (BMF). (f,g), immunohistochemical (IHC) staining.
Figure 2.
Figure 2.
(a-d), (h) & (e) and reticulin stain of bone marrow fibrosis (BMF). (f,g), immunohistochemical (IHC) staining.

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