Incidence, Risk Factors, and Impact on Transplant Outcomes of Cytokine Release Syndrome After Infusion of Haploidentical Stem Cells With Anti‐Thymocyte Globulin

This is the authors' abstract. We don't add key points for this paper.

BACKGROUND: Cytokine release syndrome (CRS) after graft infusion under anti-thymocyte globulin (ATG)-based haploidentical (haplo)-hematopoietic stem cell transplantation is unclear. OBJECTIVE: The purpose of this study was to explore the clinical implications of CRS after graft infusion under ATG-based haplo-SCT. STUDY DESIGN: We retrospectively analyzed the data of 259 patients who underwent haplo-SCT, graded CRS, and evaluated transplant outcomes. RESULTS: CRS occurred in 103/259 (39.8%) of the recipients. Severe CRS (Grades 3-5) was not observed. Fever was the most common manifestation (89.3%), and all cases occurred only after peripheral blood stem cell (PBSC) infusion. According to the multivariable analysis, being older than 55 years (OR 2.486 (1.124-5.496), p = 0.024), having higher CRP levels during conditioning (OR 3.011 (95% CI, 1.766-5.134), p < 0.001), and receiving PBSC as the sole stem cell source (OR 2.478 (95% CI, 1.077-5.700), p = 0.033) could predict the development of CRS, whereas an HCT-CI score ≥ 2 was an independent risk factor for Grade 2 CRS (OR 4.259 (95% CI, 1.515-11.969, p = 0.006)). The 3-year OS was not significantly different between the two groups, with 79% (95% CI, 61-97) for Grade 2 CRS and 85% (95% CI, 80-90) for Grade 0-1 CRS (p = 0.288). The GRFS rates in the two groups were 69% (95% CI, 49-90) and 67% (95% CI, 60-74), respectively (p = 0.644). CONCLUSION: Our results suggest that CRS is common in patients receiving ATG-based haplo-SCT and does not affect survival.