2022 Chinese ...gkin lymphoma_Ping Li.pdf

Cancer Biol Med 2023.doi:10.20892/j.issn.2095-3941.2022.0585CONSENSUS2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphomaPing Li1*,Yang Liu2*,Yun Liang3*,Jian Bo4,Sujun Gao5,Yongxian Hu6,Yu Hu7,He Huang6,Xiaojun Huang8,Hongmei Jing9,Xiaoyan Ke9,Jianyong Li10,Yuhua Li11,Qifa Liu12,Peihua Lu13,Heng Mei7,Ting Niu14,Yongping Song15,Yuqin Song16,Liping Su17,Sanfang Tu11,Jianxiang Wang18,Depei Wu19,Zhao Wang20,Kailin Xu21,Zhitao Ying16,Qingming Yang2,Yajing Zhang2,Fengxia Shi2,Bin Zhang22,Huilai Zhang23,Xi Zhang24,Mingfeng Zhao25,Weili Zhao26,Xiangyu Zhao8,Liang Huang27,Jun Zhu16,Wenbin Qian3,Weidong Han2,Aibin Liang11Department of Hematology,Shanghai Tongji Hospital,Tongji University School of Medicine,Shanghai 200065,China;2Department of Bio-therapeutic,Chinese PLA General Hospital,Beijing 100853,China;3Department of Hematology,The Second Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310009,China;4Department of Hematology,Chinese PLA General Hospital,Beijing 100853,China;5Department of Hematology,The First Hospital of Jilin University,Changchun 130012,China;6Center for Bone Marrow Transplantation,The First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310058,China;7Institute of Hematology,Union Hospital of Tongji Medical College;Huazhong University of Science and Technology,Wuhan 430022,China;8Peking University Peoples Hospital&Peking University Institute of Hematology,Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation,Beijing 100044,China;9Department of Hematology,Lymphoma Research Center,Peking University Third Hospital,Beijing 100191,China;10Department of Hematology,The First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,China;11Department of Hematology,Zhujiang Hospital,Southern Medical University,Guangzhou 510280,China;12Department of Hematology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;13Lu Daopei Institute of Hematology,Beijing 101102,China;14Department of Hematology,West China Hospital,Sichuan University,Chengdu 610041,China;15The Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China;16Department of Lymphoma,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Peking University Cancer Hospital and Institute,Beijing 100142,China;17Department of Hematology,Shanxi Cancer Hospital,Taiyuan 030013,China;18State Key Laboratory of Experimental Hematology,National Clinical Research Center for Blood Diseases,Division of Pediatric Blood Disease Center,Institute of Hematology&Blood Disease Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Tianjin 300020,China;19Department of Hematology,The First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,National Clinical Research Center for Hematologic Diseases,Suzhou 215006,China;20Department of Hematology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;21Department of Hematology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China;22Institute of Blood and Marrow Transplantation,The Fifth Medical Center,Chinese PLA General Hospital,Beijing 100039,China;23Department of Lymphoma,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjins Clinical Research Center for Cancer,Tianjin 300060,China;24Medical Center of Hematology,Xinqiao Hospital,State Key Laboratory of Trauma,Burn and Combined Injury,Army Medical University,Chongqing 400037,China;25Department of Hematology,Tianjin First Central Hospital,Tianjin 300192,China;26Department of Hematology,Shanghai Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;27Department of Hematology,Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,ChinaABSTRACT Adoptive cellular immunotherapy with chimeric antigen receptor(CAR)T cells has emerged as a novel modality for treating relapsed and/or refractory B-cell non-Hodgkin lymphoma(B-NHL).With increasing approval of CAR T-cell products and advances in CAR T cell therapy,CAR T cells are expected to be used in a growing number of cases.However,CAR T-cell-associated toxicities can be severe or even fatal,thus compromising the survival benefit from this therapy.Standardizing and studying the clinical management of these toxicities are imperative.In contrast to other hematological malignancies,such as acute lymphoblastic leukemia and multiple myeloma,anti-CD19 CAR T-cell-associated toxicities in B-NHL have several distinctive features,most notably local cytokine-release syndrome(CRS).However,previously published guidelines have provided few specific recommendations for the grading and management of toxicities associated