Table 2.
Occurrence and characteristics of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in the 84 patients
|
N (%) or Median [IQR] |
|
|---|---|
| Patients with CRS | 80 (95.2) |
| CRS grade (n = 80) a | |
| 1 | 33/80 (41.3) |
| 2 | 29/80 (36.3) |
| 3 | 15/80 (18.8) |
| 4 | 3/80 (3.8) |
| Fever duration (days) | 5 [3–7] |
| Time from fever to hypotension (days) | 2 [1–3.75] |
| Time from fever onset to peak CRS severity (days) | 5 [2–7] |
| CRS-associated complications | |
| HLH without DIC | 8/80 (10) |
| HLH and DIC | 7/80 (8.8) |
| DIC without HLH | 1/80 (1.3) |
| Patients with ICANS | 46 (54.8) |
| ICANS grade (n = 46) a | |
| 1 | 9/46 (19.6) |
| 2 | 8/46 (17.4) |
| 3 | 15/46 (32.6) |
| 4 | 14/46 (30.4) |
| Time to neurological symptoms resolution (days) | 5 [3–8] |
| Time from CRS to ICANS (days) b | 3 [2–4] |
| Time from neurological symptoms onset to peak ICANS severity (days) | 1 [0–2] |
| Investigations for ICANS | |
| Cerebral computed tomography | 37/46 (80.4) |
| Basal ganglia hypodensities | 2/37 (5.4) |
| Cerebral magnetic resonance imaging | 29/46 (63) |
| Abnormal findings c | 11/29 (37.9) |
| Lumbar puncture | 36/49 (78.3) |
| Abnormal findings | 25/36 (69.4) |
| Protein elevation ≥ 0.5 g/L | 25/36 (69.4) |
| Pleocytosis ≥ 10/mm3 | 9/36 (25) |
| Electroencephalography | 39/46 (84.8) |
| Abnormal findings | 39/39 (100) |
| Non-specific encephalopathy | 33/39 (84.6) |
| Seizures | 6/39 (15.4) |
| Status epilepticus | 3/39 (7.7) |
HLH Haemophagocytic lymphohistiocytosis, DIC disseminated intravascular coagulation
a The maximum grade for each patient is reported
b All patients with ICANS had CRS
c Basal ganglia and/or white matter FLAIR hypersignals with inconsistent contrast enhancement