Abstract P-269: BLOOD PURIFICATION TREATMENT FOR SEVERE CYTOKINE RELEASE SYNDROME AFTER CHIMERIC ANTIGEN RECEPTOR T CELL THERAPY: CASE REPORT AND LITERATURE REVIEW.

Abstract

Aims & Objectives: To evaluate the effectiveness of Blood Purification treatment for Severe Cytokine Release Syndrome after Chimeric Antigen Receptor T cell Therapy in pediatrics relapsed acute lymphoblastic leukemia. Methods We reported a case of 11 years old boy with relapsed ALL developed the severe CRS rapidly after treated with CAR-T therapy and reviewed the literature. Results The boy developed to severe cytokine-release syndrome rapidly after treated with CAR-T cellular therapy within 3 days. The CRS was characterized as high fever, hypotension, capillary leakage, edema and high IL-6 level in blood (20587pg/ml). After the failure of the anti-IL-6 antibody treatment, this patient was treated with blood purification combined with plasma exchange and CVVHDF in emergency, and the CRS was ultimately controlled. This paper reported the treatment process of rapid introduction of blood purification therapy for severe CRS in PICU, By searching the literature, we found that severe CRS patients required intensive care with respiratory support (nasal cannula or mechanical ventilation) and vasopressor support. Serum IL-6 levels was positive collected with the severity of CRS after CAR-T-cell Therapy. Anti-IL-6 antibody therapy has been recommended for severe CRS, but seldom literature reported blood purification used in severe CRS. Conclusions Blood purification has advantage of eliminated inflammatory cytokines for the treatment of CRS after CAR-T.We provided a promising alternative to treating severe CRS after the failure of conventional therapy such as anti-IL-6 antibody treatment in CAR-T therapy patients.