Looking Out for CAR T-Cell Therapy Side Effects
- CAR T-Cell Therapy has revolutionized treatment for relapsed or refractory diffuse large B-cell lymphoma, offering new hope—but it also comes with serious risks, including a potentially life-threatening reaction called Cytokine Release Syndrome (CRS).
- CRS affects up to 90% of CAR T-Cell Therapy patients and occurs when the immune system becomes hyperactivated, triggering symptoms like fever, chills, rapid heartbeat, and extreme fatigue.
Dr. Premal Lulla, an associate professor of medicine and medical oncologist from Baylor College of Medicine, is one of many experts in the Houston metropolitan area leading the charge on making Houston an epicenter for offering patients access to CAR T-Cell Therapy, which must be administered at specialized treatment centers where patients can be carefully monitored for side effects of the treatment including Cytokine Release Syndrome [CRS], which happens because CAR T-Cells trigger an overpowering immune response triggering inflammation.
Read MoreWATCH: Cytokine Release Syndrome: A CAR T-Cell Therapy Side Effect
Expert Resources for Managing CAR T-Cell Therapy Side Effects
- What is Cytokine Release Syndrome (CRS) and How is It Managed?
- CAR T-Cell Therapy Side Effects Can Be Serious, But Many Are Short-Lived
- CAR T-Cell Therapy: Making Your Body a More Efficient Cancer Fighter
- CAR T-Cell Therapy: What You Should Know About Side Effects
- Cytokine Release Syndrome: A CAR T-Cell Therapy Side Effect
- You’ve Just Had CAR T-Cell Therapy: What to Expect Now
How Will My Doctor Know If I Have CRS?
Your care team is trained to recognize the signs of CRS early. During the first two weeks after CAR-T therapy, you’ll be closely monitored in the hospital to catch any signs of inflammation before they become serious.
Doctors use a grading system to classify how severe your CRS is, based on your symptoms, your vital signs, and the need for supportive care (like oxygen or medications to support blood pressure).
They’ll also check your blood regularly to look for markers of inflammation and infection. In some cases, additional tests like chest X-rays, CT scans, or heart monitoring may be used to get a better understanding of how your body is responding.
If you’re at home after treatment, you’ll be given clear instructions on what symptoms to watch for and when to call your doctor or return to the hospital.
How Is CRS Treated?
Cytokine Release Syndrome is usually treated by calming the immune system and reducing inflammation while still allowing the cancer-fighting therapy to work.
- The first-line treatment is often tocilizumab (Actemra), a drug that blocks IL-6, one of the key inflammatory signals driving CRS. Many patients respond quickly to this medication, often within hours.
- If symptoms continue or become more severe, doctors may add steroids, such as dexamethasone, to further control the immune response. Throughout this period, patients are closely monitored—typically in a hospital setting—so the care team can support blood pressure, oxygen levels, and organ function if needed.
With these tools and standardized treatment guidelines, most cases of CRS today are manageable and temporary, allowing patients to continue benefiting from CAR T-cell therapy.
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