Correlation of IL-6 secretion and hyponatremia with the use of CD19+ chimeric antigen receptor T-cells Journal Article


Authors: Dixon, B. N.; Daley, R. J.; Buie, L. W.; Hsu, M.; Park, J. H.; Brentjens, R. J.; Purdon, T. J.; Latcha, S.
Article Title: Correlation of IL-6 secretion and hyponatremia with the use of CD19+ chimeric antigen receptor T-cells
Abstract: Background: Various studies have demonstrated that interleukin-6 (IL-6) activates the central magnocellular arginine vasopressin (AVP)-secreting neurons in the brain to produce non-osmotic, non-volumemediated increases in AVP. The most common toxicity of CD19+ chimeric antigen receptor (CAR) T-cells is cytokine release syndrome, which is related to increased levels of IL-6. This study will evaluate the correlation of IL-6 levels with hyponatremia in patients receiving CD19+ CAR T-cells. Materials and methods: This is a single-center retrospective analysis of adult patients who received CD19+ CAR T-cells for the treatment of relapsed/refractory acute lymphoblastic leukemia (ALL). Results: Hyponatremia, defined as a serum sodium (Na) <= 135 mEq/L, occurred in 31 (61%) patients. A change in Na > 7 mEq occurred in 32 (63%) patients, and the median lowest Na was 133 mEq/L (interquartilc range (IQR): 131 - 136)). There was an inverse linear relationship between IL-6 levels and lowest Na (p = 0.001). Overall, per 10-fold increase in IL-6, Na decreased by an average of 2.68 mEq/L. Conclusion: Hyponatremia is common in patients who received CD19+ CAR T-cells. There is an inverse linear relationship between IL-6 levels and nadir Na (p = 0.001). Further studies will be needed to confirm a causative relationship between IL-6 levels and hyponatremia following CD19+ CAR T-cell infusion.
Keywords: hyponatremia; interleukin-6; vasopressin; activation; il-6; pituitary-adrenal axis; cd19+car t-cells
Journal Title: Clinical Nephrology
Volume: 93
Issue: 1
ISSN: 0301-0430
Publisher: Dustri-Verlag Dr. Karl Feistle  
Date Published: 2020-01-01
Start Page: 42
End Page: 46
Language: English
ACCESSION: WOS:000500921800006
DOI: 10.5414/cn109872
PROVIDER: wos
PUBMED: 31670650
Notes: Article -- Source: Wos
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Citation Impact
MSK Authors
  1. Meier Hsu
    118 Hsu
  2. Renier J Brentjens
    233 Brentjens
  3. Sheron Latcha
    19 Latcha
  4. Jae Hong Park
    178 Park
  5. Terence John Purdon
    49 Purdon
  6. Larry Wayne Buie
    15 Buie
  7. Ryan Joseph Daley
    11 Daley
  8. Brianne N Dixon
    5 Dixon