Risk factors, prevention, and management of CRS
| . | Risk factors . | Prevention . | Treatment . |
|---|---|---|---|
| CAR T cells | Disease burden | Pretreatment cytoreduction | Fever: symptom management, acetaminophen |
| High dose Degree of lymphodepletion | Future directions: Dose adjustment by disease burden Fractionated dosing schemes | CRS: protocol-dependent anticytokine intervention with tocilizumab ± corticosteroids | |
| Blinatumomab | Disease burden Starting dose | Pretreatment cytoreduction Lower dose week 1 | Fever/CRS: paracetamol/ acetaminophen and/or dexamethasone. |
| 20 mg dexamethasone day 1, with dose escalation and with restarting drug | Grade 3 CRS: hold drug until resolution then restart at 9 µg/day with escalation to 28 µg/day after 7 d if toxicity does not recur | ||
| Grade 4 CRS: consider discontinuation | |||
| Tocilizumab has been successful in cases of CRS refractory to holding agent and giving corticosteroids |
| . | Risk factors . | Prevention . | Treatment . |
|---|---|---|---|
| CAR T cells | Disease burden | Pretreatment cytoreduction | Fever: symptom management, acetaminophen |
| High dose Degree of lymphodepletion | Future directions: Dose adjustment by disease burden Fractionated dosing schemes | CRS: protocol-dependent anticytokine intervention with tocilizumab ± corticosteroids | |
| Blinatumomab | Disease burden Starting dose | Pretreatment cytoreduction Lower dose week 1 | Fever/CRS: paracetamol/ acetaminophen and/or dexamethasone. |
| 20 mg dexamethasone day 1, with dose escalation and with restarting drug | Grade 3 CRS: hold drug until resolution then restart at 9 µg/day with escalation to 28 µg/day after 7 d if toxicity does not recur | ||
| Grade 4 CRS: consider discontinuation | |||
| Tocilizumab has been successful in cases of CRS refractory to holding agent and giving corticosteroids |