Case Report: Cytokine adsorption during multimodal management of hyperinflammatory toxicities following CAR-T in three patients

Chimeric antigen receptor T cell (CAR-T) has advanced rapidly in hematologic malignancies and even solid tumors, but post-treatment adverse reactions remain a major risk. Most adverse reactions are associated with inflammatory responses and cytokine release, such as cytokine release syndrome. Cytokine adsorption is an extracorporeal blood-purification approach designed to adsorb circulating inflammatory mediators. We report three patients with CAR-T-associated CRS, CRS with ICANS, or CRS with IEC-HS who received CA330-based cytokine adsorption as part of multimodal management. Clinical recovery and reductions in selected inflammatory markers were observed during the treatment course, and no procedure-related adverse events were documented. However, because adsorption overlapped with anti-IL-6 therapy, corticosteroids, anti-infective and supportive care, and the natural evolution of these toxicities, its independent contribution could not be determined. These observations support the feasibility of this approach and warrant prospective evaluation.