TY - JOUR
T1 - Cytokine release syndrome after haploidentical hematopoietic cell transplantation
T2 - an international multicenter analysis
AU - Abboud, Ramzi
AU - Wan, Fei
AU - Mariotti, Jacopo
AU - Arango, Marcos
AU - Castagna, Luca
AU - Romee, Rizwan
AU - Hamadani, Mehdi
AU - Chhabra, Saurabh
N1 - Funding Information:
RA has research funding from Incyte Corporation. MH has research support/funding from: Takeda Pharmaceutical Company; Spectrum Pharmaceuticals; Astellas Pharma. Consultancy: Janssen; Incyte Corporation; ADC Therapeutics; Celgene Corporation; Omeros, Verastem, MorphoSys. Speaker’s Bureau: Sanofi Genzyme, AstraZeneca, BeiGene. The authors have no other conflicts relevant to this publication.
Funding Information:
RA is supported by the American Society of Hematology Clinical Research Training Institute, the American Society of Hematology Research Training Award for Fellows, and the National Cancer Institute of the National Institutes of Health under Award Number R25 CA190190.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2021/11
Y1 - 2021/11
N2 - Haploidentical related donor transplantation (haplo-HCT) is associated with cytokine release syndrome (CRS). We conducted a multicenter retrospective study to analyze risk factors for CRS and outcomes after haplo-HCT. We included 451 patients from four academic centers receiving both peripheral blood and bone marrow grafts. Severe CRS was more common with PB vs. BM grafts (19.5% vs 4.9%, OR 2.9, p = 0.05). Multivariable analysis identified recipient CMV sero-positivity, prior transplant, HCT-CI score and donor–recipient sex mismatch as risk factors for severe CRS. Outcomes were analyzed with no CRS as the comparison group. Overall survival (OS) was superior with mild CRS (HR 0.64, p = 0.05) and worst with severe CRS (HR 2.12, p = 0.0038). Relapse risk was significantly decreased in both mild CRS (HR 0.38, p < 0.0001) and severe CRS (HR 0.17, p < 0.0001) groups. The risk of non-relapse mortality was notably higher in severe CRS group (HR 8.0, p < 0.0001), but not in mild CRS group. Acute GVHD was similar among groups. Chronic GVHD at 1 year was 18.5% for no CRS, 23% for mild CRS, and 4.3% for severe CRS (p = 0.0023), with the competing risk of early mortality and short follow up of surviving patients contributing to the low chronic GVHD rates in the severe CRS group.
AB - Haploidentical related donor transplantation (haplo-HCT) is associated with cytokine release syndrome (CRS). We conducted a multicenter retrospective study to analyze risk factors for CRS and outcomes after haplo-HCT. We included 451 patients from four academic centers receiving both peripheral blood and bone marrow grafts. Severe CRS was more common with PB vs. BM grafts (19.5% vs 4.9%, OR 2.9, p = 0.05). Multivariable analysis identified recipient CMV sero-positivity, prior transplant, HCT-CI score and donor–recipient sex mismatch as risk factors for severe CRS. Outcomes were analyzed with no CRS as the comparison group. Overall survival (OS) was superior with mild CRS (HR 0.64, p = 0.05) and worst with severe CRS (HR 2.12, p = 0.0038). Relapse risk was significantly decreased in both mild CRS (HR 0.38, p < 0.0001) and severe CRS (HR 0.17, p < 0.0001) groups. The risk of non-relapse mortality was notably higher in severe CRS group (HR 8.0, p < 0.0001), but not in mild CRS group. Acute GVHD was similar among groups. Chronic GVHD at 1 year was 18.5% for no CRS, 23% for mild CRS, and 4.3% for severe CRS (p = 0.0023), with the competing risk of early mortality and short follow up of surviving patients contributing to the low chronic GVHD rates in the severe CRS group.
UR - http://www.scopus.com/inward/record.url?scp=85118450650&partnerID=8YFLogxK
U2 - 10.1038/s41409-021-01403-w
DO - 10.1038/s41409-021-01403-w
M3 - Article
C2 - 34262142
AN - SCOPUS:85118450650
SN - 0268-3369
VL - 56
SP - 2763
EP - 2770
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 11
ER -