متلازمة إفراز السيتوكين بعد علاج الخلايا التائية CAR T أو الرابط الثنائي الخصوصية للخلايا التائية في المايلوما المتعددة

References

DOI: 10.1038/s41571-025-01041-x

• CRS is a systemic inflammatory response mediated by the activation of T lymphocytes, observed mainly after treatment with BCMA-targeted CAR T cells or bispecific T cell engagers.
• For grade 2 CRS, give an intravenous fluid bolus of 500–1,000 ml to maintain a systolic blood pressure of >90 mmHg; administer tocilizumab (8 mg/kg infused over 1 h) early if fever of ≥39°C persists, or if hypotension persists after administration of the initial fluid bolus or initiation of oxygen supplementation [II, B].
• If hypotension persists after administration of a second fluid bolus and tocilizumab, transfer to the intensive care unit for consideration of low-dose vasopressor therapy.
• Add dexamethasone (10 mg intravenously every 6 h) if hypotension persists, especially after anti-IL-6 therapy [panel consensus; IV, C].