Severe Cytokine Release Syndrome after Haploidentical Peripheral Blood Stem Cell Transplantation

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Inflammatory cytokines released by activated lymphocytes and innate cells in the context of cellular therapy can cause fever, vasodilatation, and end-organ damage, collectively known as cytokine release syndrome (CRS). CRS can occur after allogeneic blood or marrow transplantation, but is especially prevalent after HLA-haploidentical (haplo) peripheral blood transplantation (PBT). We reviewed charts of all patients who underwent haplo-PBT between October 1, 2013, and September 1, 2017 and graded CRS in these patients. A total of 146 consecutive patients who underwent related haplo-PBT were analyzed. CRS occurred in 130 patients (89%), with most cases of mild severity (grade 0 to 2). Severe CRS (grade 3 to 5) occurred in 25 patients (17%). In this group with severe CRS, 13 patients had encephalopathy, 12 required hemodialysis, and 11 were intubated. Death from the immediate complications of CRS occurred in 6 patients (24% of the severe CRS group and 4% of the entire haplo-PBT cohort). The cumulative probability of nonrelapse mortality (NRM) was 38% at 6 months for the patients with severe CRS and 8% (121 of 146) in patients without severe CRS. In conclusion, CRS occurs in nearly 90% of haplo-PBTs. Older haplo-PBT recipients (odds ratio [OR], 2.4; 95% confidence interval [CI],.83 to 6.75; P =.11) and those with a history of radiation therapy (OR, 3.85; 95% CI, 1.32 to 11.24; P =.01) are at increased risk of developing severe CRS. Although most recipients of haplo-PBT develop CRS, <20% experience severe complications. The development of severe CRS is associated with a significantly increased risk of NRM.

Original languageEnglish (US)
Pages (from-to)2431-2437
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Issue number12
StatePublished - Dec 2019


  • Class II mismatch
  • Cytokine release syndrome
  • Haploidentical
  • Peripheral blood

ASJC Scopus subject areas

  • Hematology
  • Transplantation


Dive into the research topics of 'Severe Cytokine Release Syndrome after Haploidentical Peripheral Blood Stem Cell Transplantation'. Together they form a unique fingerprint.

Cite this