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Blood. 2014 Jul 10;124(2):188-95. doi: 10.1182/blood-2014-05-552729. Epub 2014 May 29.

Current concepts in the diagnosis and management of cytokine release syndrome.

Author information

Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD;
Seattle Children's Hospital, Seattle, WA;
Division of Hematology-Oncology, University of Pennsylvania, Philadelphia, PA;
Texas Children's Hospital, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; and.
Division of Hematology-Oncology, University of Pennsylvania, Philadelphia, PA; Children's Hospital of Philadelphia Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Erratum in

  • Blood. 2015 Aug 20;126(8):1048. Dosage error in article text.


As immune-based therapies for cancer become potent, more effective, and more widely available, optimal management of their unique toxicities becomes increasingly important. Cytokine release syndrome (CRS) is a potentially life-threatening toxicity that has been observed following administration of natural and bispecific antibodies and, more recently, following adoptive T-cell therapies for cancer. CRS is associated with elevated circulating levels of several cytokines including interleukin (IL)-6 and interferon γ, and uncontrolled studies demonstrate that immunosuppression using tocilizumab, an anti-IL-6 receptor antibody, with or without corticosteroids, can reverse the syndrome. However, because early and aggressive immunosuppression could limit the efficacy of the immunotherapy, current approaches seek to limit administration of immunosuppressive therapy to patients at risk for life-threatening consequences of the syndrome. This report presents a novel system to grade the severity of CRS in individual patients and a treatment algorithm for management of CRS based on severity. The goal of our approach is to maximize the chance for therapeutic benefit from the immunotherapy while minimizing the risk for life threatening complications of CRS.

[Indexed for MEDLINE]
Free PMC Article

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