Laryngeal edema as a symptom of local cytokine release syndrome after BCMA-targeting CAR-T therapy for relapsed and refractory multiple myeloma.
Int J Hematol
; 118(5): 647-651, 2023 Nov.
Article
in En
| MEDLINE
| ID: mdl-37436678
ABSTRACT
Cytokine release syndrome (CRS) can be a major side effect of chimeric antigen receptor T-cell (CAR-T) therapy, and may occasionally become life-threatening in patients with factors such as high tumor burden or poor performance status. Among the many CRS events observed in B-cell maturation antigen (BCMA)-targeting CAR-T therapy, local symptoms (also called local CRS) are poorly understood due to their low frequency. Here, we present the case of a 54-year-old woman with refractory multiple myeloma exhibiting laryngeal edema as a local CRS. Before CAR-T therapy, she was diagnosed with progressive disease indicated by a left thyroid mass. After local irradiation, she received the BCMA-targeting CAR-T agent idecabtagene vicleucel (ide-cel). On day 2, the patient developed CRS, which resolved on treatment with tocilizumab. However, on day 4, laryngeal edema worsened, and was judged to be a local CRS. Intravenous dexamethasone rapidly reduced this edema. In conclusion, laryngeal edema rarely occurs as a local CRS, and to the best of our knowledge, has never been reported after ide-cel infusion. Dexamethasone was effective for reducing the local reaction that persisted after treatment of systemic symptoms with tocilizumab.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Laryngeal Edema
/
Receptors, Chimeric Antigen
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Multiple Myeloma
Type of study:
Diagnostic_studies
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
Int J Hematol
Journal subject:
HEMATOLOGIA
Year:
2023
Document type:
Article
Affiliation country: