Faculty Sponsor

Jana Stedman

College

College of Nursing & Health Professions (CONHP)

Department/Program

Valparaiso University Physician Assistant Program

Presentation Type

Poster Presentation

Symposium Date

Summer 7-23-2026

Abstract

Objective

The purpose of this paper is to explore whether prophylactic use of tocilizumab in patients with B-cell malignancies receiving CD19 Chimeric Antigen Receptor T-cell (CAR-T) therapy reduces the incidence of severe Cytokine Release Syndrome (CRS) within 30 days when compared to standard initiation of tocilizumab.

Methods

A literature search was conducted using PubMed, Google Scholar, ClinicalTrials.gov, and the Christopher Center Library to identify studies evaluating tocilizumab for CRS in patients receiving CD19-directed CAR T-cell therapy. Studies involving patients with B-cell malignancies treated with CD19 CAR T-cell therapy were included, while studies involving non–B-cell malignancies, non-CD19 CAR T-cell therapy, or fewer than five participants were excluded. Outcomes included severe CRS (grade 3–4) and intensive care unit (ICU) admission rates.

Results

Across the reviewed studies, prophylactic initiation of tocilizumab when compared with standard initiation was associated with decreased rates of severe CRS (grades 3-4) and ICU admissions. A prospective study demonstrated a reduction in grade 4 CRS from 50 to 27% with preemptive tocilizumab. Another prospective study showed a 2% incidence of grade 3 CRS, no cases of grade 4 CRS, and no ICU admissions.

Conclusion

Current evidence suggests that prophylactic use of tocilizumab may reduce the severity of CRS and ICU admissions. However, data ultimately remains limited and there is not yet enough evidence to conclude that prophylactic tocilizumab should replace standard initiation.

Keywords

Cytokine Release Syndrome, tocilizumab, B-cell malignancies, Chimeric Antigen Receptor T-cell Therapy, CD19, intensive care unit

Biographical Information about Author(s)

My name is Anna Guistolisi, I am currently in the Valparaiso University Physician Assistant Program with an anticipated graduation date of July 2026. My favorite rotations were hematology/oncology and ICU and I plan to pursue a career in hematology/oncology. My favorite memory from rotations performing my first marrow biopsy! I was inspired to research Preemptive Tocilizumab in CD19 CAR-T Cell Therapy because of my special interest in both hematology/oncology and intensive care.

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