Corticosteroids do not influence the efficacy and kinetics of CAR-T cells for B-cell acute lymphoblastic leukemia
Shuangyou Liu, Biping Deng, Zhichao Yin, Jing Pan, Yuehui Lin, Zhuojun Ling, Tong Wu, Dong Chen, Alex H. Chang, Zhiyong Gao, Yanzhi Song, Yongqiang Zhao, Chunrong Tong
Abstract
Chimeric antigen receptor (CAR) T-cell therapy has been demonstrated as a promising immunotherapeutic approach for treating the patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) 1 , 2 , 3 . However, cytokine release syndrome (CRS), the most prominent toxicity of CAR-T cell therapy, could be serious and even life-threatening 4 , 5 . Tocilizumab, an IL-6 receptor antagonist, has been widely used to treat CRS-related toxicities 5 , 6 , 7 , although corticosteroids could effectively abrogate CRS as well 4 , 5 , several earlier cases showed steroids may inhibit CAR T-cell persistence and their antimalignancy efficacy 7 , 8 , making corticosteroid therapy in CRS be often reserved for failure of tocilizumab or for neurologic toxicity since tocilizumab could not cross the blood-brain barrier. In our center, we use corticosteroids instead of tocilizumab as the first-line agent to manage CRS, here, we assessed the influence of steroids on the treatment effect and kinetics of CAR-T cells by comparing the difference between two groups of B-ALL patients who did (42 cases) or did not (26 cases) accept steroids.