Cytokine Release Syndrome With the Novel Treatments of Acute Lymphoblastic Leukemia: Pathophysiology, Prevention, and Treatment

Curr Oncol Rep. 2019 Jan 21;21(1):4. doi: 10.1007/s11912-019-0753-y.


Purpose of review: T cell-based therapies (blinatumomab and CAR T cell therapy) have produced unprecedented responses in relapsed and refractory (r/r) acute lymphoblastic leukemia (ALL) but is accompanied with significant toxicities, of which one of the most common and serious is cytokine release syndrome (CRS). Here we will review the pathophysiology, prevention, and treatment of CRS.

Recent findings: Efforts have been initiated to define and grade cytokine release syndrome (CRS), to identify patients at risk, to describe biomarkers that predict onset and severity, to understand the pathophysiology, and to prevent and treat severe cases to reduce T cell immunotherapy-related morbidity and mortality. Optimizing the timing of T cell-based therapies in ALL, identifying new biomarkers, and investigating novel anti-cytokine agents that have anti-CRS activity are likely to be fruitful avenues of study.

Keywords: Acute lymphoblastic leukemia; Blinatumomab; Chimeric antigen receptor; Cytokine release syndrome; Immunotherapy; T cell therapy.

Publication types

  • Review

MeSH terms

  • Cytokine Release Syndrome / etiology
  • Cytokine Release Syndrome / physiopathology*
  • Cytokine Release Syndrome / therapy*
  • Cytokines / metabolism*
  • Humans
  • Immunotherapy / adverse effects*
  • Immunotherapy, Adoptive / adverse effects*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*


  • Cytokines