Clinical characteristics of cytokine release syndrome after haploidentical hematopoietic stem cell transplantation for thalassemia major

ZHOU Xiao-Hui; WANG Xiao-Dong; LIN Qi-Hong; WANG Chun-Jing; YANG Chun-Lan; LI Yue; ZHANG Xiao-Ling; ZHANG Yu; YU Yue; LIU Si-Xi

doi:10.7499/j.issn.1008-8830.2406036

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Chinese Journal of Contemporary Pediatrics ›› 2024, Vol. 26 ›› Issue (12) : 1301-1307. DOI: 10.7499/j.issn.1008-8830.2406036

CLINICAL RESEARCH

Clinical characteristics of cytokine release syndrome after haploidentical hematopoietic stem cell transplantation for thalassemia major

ZHOU Xiao-Hui, WANG Xiao-Dong, LIN Qi-Hong, WANG Chun-Jing, YANG Chun-Lan, LI Yue, ZHANG Xiao-Ling, ZHANG Yu, YU Yue, LIU Si-Xi

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Abstract

Objective To investigate the clinical characteristics of cytokine release syndrome (CRS) in children with thalassemia major (TM) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT) and their prognosis. Methods A retrospective analysis was performed for the clinical data of 280 children with TM who underwent haplo-HSCT in the Department of Hematology and Oncology, Shenzhen Children's Hospital, from January 2019 to December 2021. According to the CRS criteria, they were divided into two groups: CRS grade <3 (260 children) and CRS grade ≥3 (20 children). The children with TM were analyzed in terms of clinical characteristics of CRS after haplo-HSCT and their prognosis. Results There were significant differences between the two groups in neutrophil engraftment time, clinical manifestations of CRS, and the rate of use of glucocorticoids within 4 days after haplo-HSCT (P=0.012, 0.040, and <0.001 respectively). For the CRS grade <3 group, the incidence rate of acute graft-versus-host disease (aGVHD) was 9.6% within 3 months after transplantation, while no aGVHD was observed in the CRS grade ≥3 group within 3 months after transplantation, but there was no significant difference in the incidence of aGVHD between the two groups within 3 months after transplantation (P=0.146). No transplantation-related death was observed in either group within 3 months after haplo-HSCT. Conclusions The children with CRS grade≥3 have an early neutrophil engraftment time, severe and diverse clinical manifestations of CRS, and a high rate of use of glucocorticoids within 4 days after haplo-HSCT. For these children, early use of low-dose glucocorticoids after transplantation may alleviate CRS response and reduce the incidence of aGVHD, thereby bringing more benefits to the children. CRS after haplo-HSCT has no significant impact on the prognosis of the children.

Key words

Thalassemia / Cytokine release syndrome / Haploidentical hematopoietic stem cell transplantation / Child

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ZHOU Xiao-Hui, WANG Xiao-Dong, LIN Qi-Hong, WANG Chun-Jing, YANG Chun-Lan, LI Yue, ZHANG Xiao-Ling, ZHANG Yu, YU Yue, LIU Si-Xi. Clinical characteristics of cytokine release syndrome after haploidentical hematopoietic stem cell transplantation for thalassemia major[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(12): 1301-1307 https://doi.org/10.7499/j.issn.1008-8830.2406036

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