Development of Local Cytokine Release Syndrome in a Diffuse large B-cell Lymphoma Following Chimeric Antigen Receptor T-cell Therapy, A Case Report and Literature Review.

Abstract

 We present a unique case of cervical edema-type Localized Cytokine Release Syndrome (L-CRS) following CAR T-cell therapy in an 80-year-old patient with diffuse large B-cell lymphoma (DLBCL). Despite tocilizumab’s typical efficacy in managing CRS, the patient’s L-CRS did not respond to tocilizumab but showed improvement with dexamethasone. The study emphasizes the rarity and potential severity of L-CRS, with only six similar cases reported previously. The observed variability in response to different treatments underscores the complexity of CRS manifestations, requiring tailored approaches for optimal management. This case contributes valuable insights into L-CRS, suggesting its potential manifestation independently of apparent cervical lesions and its differential response to tocilizumab and dexamethasone. Continued vigilance and exploration of management strategies are crucial in this evolving field.