Siltuximab for the treatment of early complications after chimeric antigen receptor T-cell therapy for acute lymphoblastic leukemia in children, adolescents, and young adults

Siltuximab for the treatment of early complications after chimeric antigen receptor T-cell therapy for acute lymphoblastic leukemia in children, adolescents, and young adults

Abstract Background Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are complications associated with CAR T-cell therapy. Siltuximab directly binds interleukin-6 (IL-6) and may be safe and effective as first-line therapy for CRS or ICANS. Methods A...

Full description

Saved in:
Bibliographic Details
Main Authors: Víctor Galán-Gómez, Berta González-Martínez, Anna Alonso-Saladrigues, Susana Rives, Blanca Herrero, Mi Kwon, Jose Sánchez-Pina, Jordi Minguillón, Isabel Martínez-Romera, Isabel Mirones Aguilar, Carmen Mestre-Durán, Gema Casado, María Sánchez-Martín, Carlos Echecopar, Carlos González-Pérez, Odelaisy León-Triana, Cristina Aguirre-Portolés, Águeda Molinos-Quintana, Pere Barba, Pascual Balsalobre, Antonio Pérez-Martínez
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Experimental Hematology & Oncology
Subjects:
Tocilizumab
Siltuximab
Chimeric antigen receptor—CAR
Cytokine release syndrome
Immune effector cell-associated neurotoxicity syndrome—ICANS
Neurotoxicity
Online Access:https://doi.org/10.1186/s40164-025-00638-3
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are complications associated with CAR T-cell therapy. Siltuximab directly binds interleukin-6 (IL-6) and may be safe and effective as first-line therapy for CRS or ICANS. Methods A retrospective study was conducted on pediatric, adolescent and young adult (AYA) patients treated with siltuximab after CAR T-cell therapy for B-ALL. Results A total of 118 patients treated were included: 97 patients developed CRS (82%), and 26 patients (22%) developed ICANS. Sixty-five of those that developed CRS (55%), received treatment. In 46/65 (71%), tocilizumab was administered as anti-IL-6 drug, and 19/65 (29%) patients received siltuximab to treat tocilizumab-refractory CRS (n = 13, 68%), or as first-line CRS treatment (n = 6, 32%). Nine patients treated with siltuximab (47%) developed ICANS. With a median follow-up of 12.1 months, 7 patients remained alive. Conclusions To the best of our knowledge, we present the largest reported cohort of patients treated with siltuximab for CRS following CAR T-cell therapy for B-ALL. Siltuximab’s safety profile and its inhibition of IL-6 effects suggest that it should be investigated as first-line therapy in prospective clinical trials.
ISSN:2162-3619

Similar Items