TY - JOUR
T1 - The impact of tocilizumab treatment for cytokine release syndrome on the incidence of early blood stream infections after peripheral blood haploidentical hematopoietic cell transplantation
AU - De Togni, Elisa
AU - Wan, Fei
AU - Slade, Michael
AU - Plach, Kelly
AU - Abboud, Ramzi
N1 - Funding Information:
MS was supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number TL1TR002344. RA is supported by the American Society of Hematology Research Training Award for Fellows and the National Cancer Institute of the National Institutes of Health under Award Number K12 CA167540 and R25 CA190190. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
RA has research funding from Incyte Corporation. The authors have no other conflicts relevant to this publication.
Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Cytokine release syndrome (CRS) is a potentially fatal systemic inflammatory response that can occur in patients undergoing peripheral blood haploidentical hematopoietic cell transplantation (haplo-HCT). Severe CRS has previously been associated with increased infection risk. IL-6 inhibitors, such as tocilizumab, are useful in moderate to severe CRS, but their effect on infection risk has not been established in this setting. We examined the effect of tocilizumab on blood stream infections (BSIs) in the early post-transplant period in 235 patients who underwent haplo-HCT from 2013 to 2020. Mild CRS was associated with a lower incidence of BSI than severe CRS (OR 0.31, 95% CI 0.13–0.74). In the tocilizumab group, 31% of patients had positive blood cultures versus 14% in the non-tocilizumab group (OR 1.61, 95% CI 0.30–8.60, p = 0.58). However, when controlling for CRS grade, tocilizumab was not independently associated with increased rates of BSIs, suggesting it does not further increase infection risk.
AB - Cytokine release syndrome (CRS) is a potentially fatal systemic inflammatory response that can occur in patients undergoing peripheral blood haploidentical hematopoietic cell transplantation (haplo-HCT). Severe CRS has previously been associated with increased infection risk. IL-6 inhibitors, such as tocilizumab, are useful in moderate to severe CRS, but their effect on infection risk has not been established in this setting. We examined the effect of tocilizumab on blood stream infections (BSIs) in the early post-transplant period in 235 patients who underwent haplo-HCT from 2013 to 2020. Mild CRS was associated with a lower incidence of BSI than severe CRS (OR 0.31, 95% CI 0.13–0.74). In the tocilizumab group, 31% of patients had positive blood cultures versus 14% in the non-tocilizumab group (OR 1.61, 95% CI 0.30–8.60, p = 0.58). However, when controlling for CRS grade, tocilizumab was not independently associated with increased rates of BSIs, suggesting it does not further increase infection risk.
KW - Tocilizumab
KW - bloodstream infection
KW - cytokine release syndrome (CRS)
KW - haploidentical
KW - hematopoietic stem cell transplantation
UR - http://www.scopus.com/inward/record.url?scp=85134153395&partnerID=8YFLogxK
U2 - 10.1080/10428194.2022.2100367
DO - 10.1080/10428194.2022.2100367
M3 - Article
C2 - 35848998
AN - SCOPUS:85134153395
SN - 1042-8194
VL - 63
SP - 2975
EP - 2981
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 12
ER -