Respiratory Failure Due to Idiopathic Pneumonia Syndrome in a Pediatric Patient After Recipient-derived Allogeneic Chimeric Antigen Receptor T-Cell Therapy.
Rachelle ZipperDavid M LoebMichelle A LeeJennifer Oliver-KrasinskiMark C LiszewskiEllen FraintPublished in: Journal of pediatric hematology/oncology (2023)
Idiopathic pneumonia syndrome (IPS) is a life-threatening complication of hematopoietic cell transplantation, but it is not clearly described following chimeric antigen receptor (CAR) T-cell therapy. We describe a child who developed IPS after receiving tisagenlecleucel for post-hematopoietic cell transplantation relapsed acute lymphoblastic leukemia and had a remarkable improvement after treatment with corticosteroids and etanercept. We discuss the implications of cytokine signaling in IPS and immunologic considerations of allogeneic CAR T cells. We anticipate that the incidence of IPS and other allogeneic phenomena will be observed more often as allogeneic CAR T cells are employed in more varied settings with more mismatched donors.
Keyphrases
- stem cell transplantation
- respiratory failure
- acute lymphoblastic leukemia
- cell therapy
- bone marrow
- hematopoietic stem cell
- high dose
- extracorporeal membrane oxygenation
- mesenchymal stem cells
- mechanical ventilation
- rheumatoid arthritis
- allogeneic hematopoietic stem cell transplantation
- case report
- stem cells
- acute myeloid leukemia
- mental health
- multiple myeloma
- intensive care unit
- diffuse large b cell lymphoma
- low dose
- juvenile idiopathic arthritis
- hodgkin lymphoma
- ankylosing spondylitis
- acute respiratory distress syndrome
- community acquired pneumonia
- smoking cessation