Blood: The more cortisol is used, the worse the prognosis for patients with large B-cell lymphoma treated with CAR T cell therapy!

Corticosteroids are often used to manage severe toxicity associated with chimic antigen-treated (CAR) T-cell therapy.
, it is not clear whether the dose, duration and duration of corticosteroids will affect their clinical efficacy.
study aims to clarify the clinical prognosis of corticosteroids in patients with recurring/refractic large B-cell lymphoma treated with standard anti-CD19 CAR T cell therapy.
assessed a total of 100 patients, 60 of whom (60%) received corticosteroids to control the toxicity associated with CAR T cell therapy.
cumulative dose of 186 mg (range 8-1803 mg) and the medium cumulative duration of corticosteroid therapy was 9 days (range 1-30 days).
45 (75%) patients started using corticosteroids in the first 7 days, and 15 (25%) patients used corticosteroids for more than 7 days.
10 months (95% CI 8-12 months) after the medium follow-up, the more corticosteroids were used, the shorter the progression-free lifetime was significantly shorter.
More importantly, higher cumulative doses of corticosteroids, as well as early use of corticosteroids and extended corticosteroid use after infusion of CAR T cells, were associated with significant reductions in overall survival.
, the results show that in the management of CAR T cell therapy-related toxicity, it is possible to use corticosteroids, the dose should be as small as possible, the application time should be as short as possible, the start-up time should be as late as possible.