World J Clin Cases. Sep 16, 2022; 10(26): 9398-9403 Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9398
Cytokine release syndrome complicated with rhabdomyolysis after chimeric antigen receptor T-cell therapy: A case report
Lan Zhang, Wei Chen, Xiao-Min Wang, Shu-Qing Zhang
Lan Zhang, Wei Chen, Xiao-Min Wang, Shu-Qing Zhang, Department of Hematology, The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Author contributions: Zhang L, Wang XM, Zhang SQ are responsible for the treatment of patient; Zhang L analyzed the data and wrote the manuscript; Chen W contributed coordination and manuscript review; all authors have read and approve the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Lan Zhang, Doctor, PhD, Assistant Professor, Department of Hematology, The First Hospital of Shanxi Medical University, No. 89 Xinjian Road, Taiyuan 030001, Shanxi Province, China. qiqi994@sina.com
Received: April 14, 2022 Peer-review started: April 14, 2022 First decision: June 7, 2022 Revised: June 20, 2022 Accepted: August 6, 2022 Article in press: August 6, 2022 Published online: September 16, 2022 Processing time: 140 Days and 18.4 Hours
Core Tip
Core Tip: Cytokine release syndrome-induced rhabdomyolysis followed by chimeric antigen receptor-T (CAR-T) therapy treatment has not been previously reported. We report a case of a 22-year-old woman with relapsed acute lymphoblastic leukemia obtained sequential cluster of differentiation (CD) 19 and CD22 CAR-T cells infusion. This patient experienced grade 3 cytokine release syndrome with RM, mild hypotension requiring intravenous fluids, and mild hypoxia and was managed effectively with the interleukin-6 receptor antagonist tocilizumab. This patient had no signs of immune effector cell-associated neurologic syndrome. Restaging scans 30 d post CAR-T therapy demonstrated a complete remission, and the symptoms of muscle weakness improved through rehabilitation. Therefore, it is necessary to monitor myoglobin levels when a patient presents with symptoms of myalgia.
