Zhang L, Chen W, Wang XM, Zhang SQ. Cytokine release syndrome complicated with rhabdomyolysis after chimeric antigen receptor T-cell therapy: A case report.
World J Clin Cases 2022;
10:9398-9403. [PMID:
36159401 PMCID:
PMC9477680 DOI:
10.12998/wjcc.v10.i26.9398]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/20/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND
Chimeric antigen receptor T-Cell (CAR-T) therapy is an effective new treatment for hematologic malignancies. Cytokine release syndrome (CRS) and neurologic toxicity are main toxicities. CRS-induced rhabdomyolysis (RM) followed by CAR-T therapy treatment has not been previously reported.
CASE SUMMARY
We report a case of a 22-year-old woman with relapsed acute lymphoblastic leukemia obtained sequential cluster of differentiation (CD) 19 and CD22 CAR-T infusion. This patient experienced grade 3 CRS with RM, mild hypotension requiring intravenous fluids, and mild hypoxia and was managed effectively with the IL-6 receptor antagonist tocilizumab. This patient had no signs of immune effector cell-associated neurologic syndrome. Restaging scans 30 d postCAR-T therapy demonstrated a complete remission, and the symptoms of muscle weakness improved through rehabilitation.
CONCLUSION
Myalgia is an easily overlooked symptom of severe CRS after CAR-T therapy. It is necessary to monitor myoglobin levels when a patient presents with symptoms of myalgia or acute renal insufficiency.
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