Cytokine release syndrome and outpatient care of patients treated with CAR-T | ASH 2025

The most common and often the most serious side effect of chimeric antigen replacement T cell (CAR-T) therapy is cytokine release syndrome, a

In an interview, Christopher Ferreri, M.D., of the Atrium Health Levine Cancer Institute in Charlotte, North Carolina, discussed how outpatient care of patients treated with CAR-T has evolved to take into account cytokine release syndrome and manage it when it occurs. Ferreri was the lead author of an abstract presented at the American Society of Hematology that summarized research showing the cost advantage of post-infusion outpatient care of patients treated with Carvykti, a CAR-T therapy for multiple myeloma. Ferreri said that in some early clinical trials assessing outpatient care of patients treated with CAR-T, patients were scheduled ahead of time to be admitted on days that clinicians expected cytokine release syndrome most likely to occur. Now, for example, the protocol at Levine Cancer Institute is to manage most patients entirely on an outpatient basis but require them to live within 30 minutes of the facility for 14 days after the infusion so if they need care, they are right nearby. They also come in daily for lab tests and measurement of vital signs, Ferreri explained.

Ferreri said he and his colleagues also try to manage mild (grade 1) cases of cytokine release syndrome on an outpatient basis, whereas in the past, if there was even an "inkling" of cytokine release syndrome, patients were admitted to the hospital.