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iwAL 2025 | Risk factors for CRS and ICANS in patients receiving CAR T-cell therapy
In this video, John DiPersio, MD, PhD, Washington University School of Medicine, St. Louis, MO, comments on the risk of cytokine release syndrome (CRS) and immune-effector cell-associated neurotoxicity syndrome (ICANS) in CAR T-cell therapy recipients. He explains that risk is influenced by factors such as disease bulk, inflammation, fever, high LDH levels, and age. This interview took place at the 7th International Workshop on Acute Leukemias (iwAL 2025), held in Washington, DC.
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Transcript
There are certain CAR T-cell therapies that are known to have a higher risk of CRS, you know, depending upon the structure of the CAR-T, so we know that. There are ways to give CAR-T’s now that the risk of CRS may be reduced, like some of the newer drugs, there’s split dosing for some of them, which may reduce CRS. And then patients, the high-risk patients are patients that come to treatment with bulk disease...
There are certain CAR T-cell therapies that are known to have a higher risk of CRS, you know, depending upon the structure of the CAR-T, so we know that. There are ways to give CAR-T’s now that the risk of CRS may be reduced, like some of the newer drugs, there’s split dosing for some of them, which may reduce CRS. And then patients, the high-risk patients are patients that come to treatment with bulk disease. They have signs of actual inflammation or fever at the time they get treated, high LDH levels, poorly controlled disease, that kind of stuff. Age is also associated with a higher risk of CRS and also a higher risk of ICANS. So those kinds of things, but there’s no specific red light that you can look at and say, okay, this patient’s definitely going to get grade three or grade four CRS or ICANS. They’re just a compilation of factors and features of patients that seem to predict a higher risk of CRS and ICANS.
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