Cytokine release syndrome

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Cytokine release syndrome
Manifestations cliniques et biologiques du syndrome de libération des cytokines.jpg
Synonyms CRS
Pronounce N/A
Specialty N/A
Symptoms Fever, fatigue, headache, rash, arthralgia, myalgia, hypotension, tachycardia, dyspnea, hypoxia, nausea, vomiting, diarrhea, coagulopathy, organ dysfunction
Complications Macrophage activation syndrome, hemophagocytic lymphohistiocytosis
Onset Hours to days after treatment
Duration Variable
Types N/A
Causes Immunotherapy, monoclonal antibodies, CAR T-cell therapy
Risks High tumor burden, high intensity of therapy
Diagnosis Clinical evaluation, laboratory tests
Differential diagnosis Sepsis, anaphylaxis, tumor lysis syndrome
Prevention Pre-medication with corticosteroids, antihistamines
Treatment Corticosteroids, tocilizumab, supportive care
Medication N/A
Prognosis Variable, depends on severity and treatment
Frequency Common in patients receiving certain immunotherapies
Deaths N/A


Cytokine Release Syndrome (CRS) is a significant medical condition that can occur after the therapeutic infusion of antibodies. It is characterized by a set of symptoms resulting from the rapid release of cytokines by cells targeted by these antibodies.

Definition and Symptoms[edit | edit source]

CRS is a systemic inflammatory response marked by the release of a large number of cytokines. Common symptoms include nausea, headache, tachycardia, hypotension, rash, and shortness of breath.

Causes and Pathophysiology[edit | edit source]

CRS is often triggered by immunotherapies, such as chimeric antigen receptor (CAR) T-cell therapy, which involve the infusion of antibodies. The antibodies target specific cells, leading to their activation and the subsequent release of cytokines.

Severity and Risks[edit | edit source]

While most patients experience mild to moderate symptoms, CRS can sometimes escalate to severe and life-threatening levels. The severity depends on various factors, including the type of immunotherapy and the patient's overall health.

Diagnosis[edit | edit source]

Diagnosis of CRS is primarily based on clinical symptoms and the timing of their appearance after antibody therapy. Laboratory tests can support the diagnosis by showing elevated levels of cytokines.

Treatment and Management[edit | edit source]

Treatment of CRS is tailored to the severity of the symptoms. Mild cases may require symptomatic treatment, while severe cases might necessitate hospitalization and administration of corticosteroids or tocilizumab, a medication that blocks the cytokine interleukin-6.

Prevention Strategies[edit | edit source]

Preventive strategies in high-risk patients include dose modifications and premedication. Ongoing research aims to develop approaches to mitigate CRS while preserving the efficacy of antibody therapies.

Implications in Cancer Therapy[edit | edit source]

CRS is particularly relevant in the context of cancer therapy, where novel treatments like CAR T-cell therapy have shown promising results but also carry the risk of CRS.

See Also[edit | edit source]

References[edit | edit source]

External Links[edit | edit source]

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