PMID- 37303362
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230613
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 5
DP  - 2023 May
TI  - Cervical Local Cytokine Release Syndrome Following Chimeric Antigen Receptor 
      T-cell Therapy in Patients With Relapsed or Refractory Diffuse Large B-cell 
      Lymphoma.
PG  - e38905
LID - 10.7759/cureus.38905 [doi]
LID - e38905
AB  - The use of chimeric antigen receptor T-cell (CAR-T) therapy for hematologic 
      malignancies is rapidly increasing, and appropriately managing adverse events 
      (AEs) is crucial. Cytokine release syndrome (CRS) is a common AE of CAR-T 
      therapy, characterized by systemic symptoms such as fever and respire-circulatory 
      failure. We present two cases with relapsed or refractory diffuse large B-cell 
      lymphoma (DLBCL) accompanied by a rare complication of cervical local CRS as an 
      acute inflammatory reaction at a specific site after CAR-T infusion. Case 1: A 
      60-year-old gentleman with diffuse large B cell lymphoma (DLBCL) developed grade 
      1 CRS on day one that required three doses of tocilizumab. Then he developed 
      remarkable cervical edema as local CRS on day five. His local CRS spontaneously 
      improved from day seven without additional therapy. Case 2: A 70-year-old 
      gentleman with DLBCL developed grade 1 CRS on day two that required three doses 
      of tocilizumab. Then he developed remarkable cervical edema and muffled voice as 
      local CRS on day three. He received dexamethasone because of concerns about 
      airway obstruction, and his local CRS improved immediately after dexamethasone 
      administration. Before Tisa-Cel infusion, neither patients had a lymphoma lesion 
      in their necks. To summarize, local CRS may occur at the site without lymphoma 
      involvement after CAR-T therapy. An appropriate diagnosis and careful observation 
      are required to determine the need for additional treatment.
CI  - Copyright (c) 2023, Inoue et al.
FAU - Inoue, Yu
AU  - Inoue Y
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Fujino, Takahiro
AU  - Fujino T
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Chinen, Shotaro
AU  - Chinen S
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Niiyama-Uchibori, Yui
AU  - Niiyama-Uchibori Y
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Ide, Daisuke
AU  - Ide D
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Kawata, Moe
AU  - Kawata M
AD  - Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University 
      of Medicine, Kyoto, JPN.
FAU - Hashimoto, Keiko
AU  - Hashimoto K
AD  - Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University 
      of Medicine, Kyoto, JPN.
FAU - Takimoto-Shimomura, Tomoko
AU  - Takimoto-Shimomura T
AD  - Department of Hematology, Otsu City Hospital, Otsu, JPN.
FAU - Nakayama, Ai
AU  - Nakayama A
AD  - Department of Hematology, Otsu City Hospital, Otsu, JPN.
FAU - Tsukamoto, Taku
AU  - Tsukamoto T
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Mizutani, Shinsuke
AU  - Mizutani S
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Shimura, Yuji
AU  - Shimura Y
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
FAU - Hirano, Shigeru
AU  - Hirano S
AD  - Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University 
      of Medicine, Kyoto, JPN.
FAU - Kuroda, Junya
AU  - Kuroda J
AD  - Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural 
      University of Medicine, Kyoto, JPN.
LA  - eng
PT  - Case Reports
DEP - 20230511
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10257532
OTO - NOTNLM
OT  - chimeric antigen receptor t-cell therapy
OT  - dexamethasone
OT  - diffuse large b-cell lymphoma
OT  - local cytokine release syndrome
OT  - tocilizumab
COIS- The authors have declared financial relationships, which are detailed in the next 
      section.
EDAT- 2023/06/12 06:42
MHDA- 2023/06/12 06:43
PMCR- 2023/05/11
CRDT- 2023/06/12 03:53
PHST- 2023/05/11 00:00 [accepted]
PHST- 2023/06/12 06:43 [medline]
PHST- 2023/06/12 06:42 [pubmed]
PHST- 2023/06/12 03:53 [entrez]
PHST- 2023/05/11 00:00 [pmc-release]
AID - 10.7759/cureus.38905 [doi]
PST - epublish
SO  - Cureus. 2023 May 11;15(5):e38905. doi: 10.7759/cureus.38905. eCollection 2023 
      May.