Cytokine release syndrome

Cytokine release syndrome (CRS) is a severe, potentially life-threatening immune-mediated condition characterized by excessive cytokine secretion leading to systemic inflammation and multiorgan dysfunction. In recent decades, significant progress in cancer therapy and hematopoietic stem cell transplantation has revolutionized patient outcomes, particularly with the introduction of immune-based therapies such as Chimeric Antigen Receptor T-cell therapy, bispecific T-cell engagers, and immune checkpoint inhibitors. However, these treatments are closely associated with CRS, which arises from uncontrolled T-cell activation and cytokine amplification. The severity of CRS varies depending on disease burden, immune activation strength, and therapeutic agent. Interleukin-6 (IL-6) plays a central role in CRS pathophysiology, making IL-6 receptor blockade with Tocilizumab a cornerstone of treatment, along with corticosteroids and supportive care. Early recognition, grading, and prompt management are essential to prevent irreversible organ damage and death. Biomarkers, such as C-reactive protein and ferritin, assist in monitoring, although clinical parameters remain the basis of diagnosis and management. A proactive, multidisciplinary approach combining prevention, monitoring, and targeted therapy is crucial for improving outcomes and maintaining anti-tumor efficacy. Ongoing research aims to refine CRS prediction and optimize therapeutic strategies.