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Doctors may soon have a way to flag which autoimmune patients are most at risk for a fever-driven immune reaction after CAR T-cell therapy. A new study found that higher baseline levels of B cells and the inflammatory protein IL-6 significantly raised the odds of cytokine release syndrome (CRS). While most cases were mild, the findings could help clinicians better plan monitoring and care delivery.
CAR T-cell therapy is gaining traction as a treatment for refractory autoimmune diseases, but it comes with a notable side effect: cytokine release syndrome (CRS), a potentially serious immune overreaction. A new retrospective study of 108 patients across seven centers in Germany and China found that 80% developed CRS after receiving the therapy — though the vast majority of cases were mild (grade 1 or 2).
The key finding? Two simple blood markers measured before treatment — B-cell counts and interleukin-6 (IL-6) concentrations — were independently linked to CRS risk. Researchers identified specific cutoff values (25.66 B cells/µL and 6.82 pg/mL for IL-6) that could help stratify patients into higher- and lower-risk groups before infusion. Experts note that a low-risk profile should not be interpreted as protection against severe events.
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Why it matters: These findings offer clinicians a practical, pre-treatment tool to anticipate CRS and allocate monitoring resources accordingly — potentially enabling safer outpatient delivery of CAR T-cell therapy for autoimmune patients.
