Continuous renal replacement therapy in cytokine release syndrome following immunotherapy or cellular therapies?


Journal

Journal for immunotherapy of cancer
ISSN: 2051-1426
Titre abrégé: J Immunother Cancer
Pays: England
ID NLM: 101620585

Informations de publication

Date de publication:
05 2020
Historique:
accepted: 29 04 2020
entrez: 1 6 2020
pubmed: 1 6 2020
medline: 29 7 2021
Statut: ppublish

Résumé

Recently, an increasing number of novel drugs were approved in oncology and hematology. Nevertheless, pharmacology progress comes with a variety of side effects, of which cytokine release syndrome (CRS) is a potential complication of some immunotherapies that can lead to multiorgan failure if not diagnosed and treated accordingly. CRS generally occurs with therapies that lead to highly activated T cells, like chimeric antigen receptor T cells or in the case of bispecific T-cell engaging antibodies. This, in turn, leads to a proinflammatory state with subsequent organ damage. To better manage CRS there is a need for specific therapies or to repurpose strategies that are already known to be useful in similar situations. Current management strategies for CRS are represented by anticytokine directed therapies and corticosteroids. Based on its pathophysiology and the resemblance of CRS to sepsis and septic shock, as well as based on the principles of initiation of continuous renal replacement therapy (CRRT) in sepsis, we propose the rationale of using CRRT therapy as an adjunct treatment in CRS where all the other approaches have failed in controlling the clinically significant manifestations.

Identifiants

pubmed: 32474415
pii: jitc-2020-000742
doi: 10.1136/jitc-2020-000742
pmc: PMC7264828
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Catalin Constantinescu (C)

Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
Department of Anesthesia - Intensive Care, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.

Sergiu Pasca (S)

Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.

Tiberiu Tat (T)

Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania.

Patric Teodorescu (P)

Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania.

Catalin Vlad (C)

Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.

Sabina Iluta (S)

Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania.

Delia Dima (D)

Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania.

Dana Tomescu (D)

Department of Anesthesia - Intensive Care, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania.
Department of Anesthesia - Intensive Care, Fundeni Clinical Institute, Bucuresti, Romania.

Ecaterina Scarlatescu (E)

Department of Stem Cell Transplantation, Clinical Institute Fundeni, Bucuresti, Romania.

Alina Tanase (A)

Department of Stem Cell Transplantation, Clinical Institute Fundeni, Bucuresti, Romania.

Olafur Eysteinn Sigurjonsson (OE)

University of Reykjavik, Reykjavik, Iceland.
Bloodbank, Landspitali National University Hospital of Iceland, Reykjavik, Iceland.

Anca Colita (A)

Department of Stem Cell Transplantation, Clinical Institute Fundeni, Bucuresti, Romania.

Hermann Einsele (H)

Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Wurzburg, Bayern, Germany.

Ciprian Tomuleasa (C)

Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania ciprian.tomuleasa@umfcluj.ro.

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