Abstract
Background aims
Few studies have reported the associations of granulocyte colony-stimulating factor
(G-CSF) with cytokine release syndrome (CRS), neurotoxic events (NEs) and efficacy
after chimeric antigen receptor (CAR) T-cell therapy for relapsed or refractory (R/R)
multiple myeloma (MM). We present a retrospective study performed on 113 patients
with R/R MM who received single anti-BCMA CAR T-cell, combined with anti-CD19 CAR
T-cell or anti-CD138 CAR T-cell therapy.
Methods
Eight patients were given G-CSF after successful management of CRS, and no CRS re-occurred
thereafter. Of the remaining 105 patients that were finally analyzed, 72 (68.6%) received
G-CSF (G-CSF group), and 33 (31.4%) did not (non G-CSF group). We mainly analyzed
the incidence and severity of CRS or NEs in two groups of patients, as well as the
associations of G-CSF timing, cumulative dose and cumulative time with CRS, NEs and
efficacy of CAR T-cell therapy.
Results
Both groups of patients had similar duration of grade 3–4 neutropenia, and the incidence
and severity of CRS or NEs.There were also no differences in the incidence and severity
of CRS or NEs between patients with the timing of G-CSF administration ≤3 days and
those >3 days after CAR T-cell infusion. The incidence of CRS was greater in patients
receiving cumulative doses of G-CSF >1500 μg or cumulative time of G-CSF administration
>5 days. Among patients with CRS, there was no difference in the severity of CRS between
patients who used G-CSF and those who did not. The duration of CRS in anti-BCMA and
anti-CD19 CAR T-cell–treated patients was prolonged after G-CSF administration. There
were no significant differences in the overall response rate at 1 and 3 months between
the G-CSF group and the non–G-CSF group.
Conclusions
Our results showed that low-dose or short-time use of G-CSF was not associated with
the incidence or severity of CRS or NEs, and G-CSF administration did not influence
the antitumor activity of CAR T-cell therapy.
Key Words
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Article info
Publication history
Published online: March 11, 2023
Accepted:
January 23,
2023
Received:
August 18,
2022
Identification
Copyright
© 2023 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.
