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oai:recercat.cat:11351/120292025-05-03T03:20:09Zcom_2072_378070com_2072_378040col_2072_378092

Novel prognostic scoring systems for severe CRS and ICANS after anti-CD19 CAR T cells in large B-cell lymphoma Kirkwood, Amy A. Kwon, Mi Jain, Michael Di Blasi, Roberta SESQUES, Pierre Rejeski, Kai Barba, Pere IACOBONI, GLORIA Institut Català de la Salut [Sesques P] Hematology Department, Hospices Civils de Lyon, Lyon, France. [Kirkwood AA] Cancer Research UK & UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, UK. [Kwon M] Department of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Rejeski K] Department of Medicine III – Hematology/Oncol ogy, LMU University Hospital, LMU Munich, Munich, Germany. [Jain MD] Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moftt Cancer Center, Tampa, USA. [Di Blasi R] Hematology Department, Hôpital Saint Louis, Paris, France. [Iacoboni G, Barba P] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Citocines Immunoteràpia Antígens - Receptors Prognosi Cèl·lules B - Tumors - Immunoteràpia ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis DISEASES::Neoplasms::Neoplasms by Histologic Type::Lymphoma::Lymphoma, Non-Hodgkin::Lymphoma, B-Cell::Lymphoma, Large B-Cell, Diffuse Other subheadings::Other subheadings::/therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunization::Immunization, Passive::Adoptive Transfer::Immunotherapy, Adoptive Other subheadings::Other subheadings::Other subheadings::/adverse effects TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico ENFERMEDADES::neoplasias::neoplasias por tipo histológico::linfoma::linfoma no Hodgkin::linfoma de células B::linfoma de células B grandes difuso Otros calificadores::Otros calificadores::/terapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapia biológica::inmunomodulación::inmunoterapia::inmunización::inmunización pasiva::transferencia adoptiva::inmunoterapia adoptiva Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos SIndrome Tormenta Citocinas Cytokine release syndrome; Anti-CD19 CAR T cells; Large B-cell lymphoma Síndrome de liberación de citocinas; Células T CAR anti-CD19; Linfoma de células B grandes Síndrome d'alliberament de citocines; Cèl·lules T CAR anti-CD19; Limfoma de cèl·lules B grans Autologous anti-CD19 chimeric antigen receptor (CAR) T cells are now used in routine practice for relapsed/refractory (R/R) large B-cell lymphoma (LBCL). Severe (grade ≥ 3) cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity (ICANS) are still the most concerning acute toxicities leading to frequent intensive care unit (ICU) admission, prolonging hospitalization, and adding significant cost to treatment. We report on the incidence of CRS and ICANS and the outcomes in a large cohort of 925 patients with LBCL treated with axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) in France based on patient data captured through the DESCAR-T registry. CRS of any grade occurred in 778 patients (84.1%), with 74 patients (8.0%) with grade 3 CRS or higher, while ICANS of any grade occurred in 375 patients (40.5%), with 112 patients (12.1%) with grade ≥ 3 ICANS. Based on the parameters selected by multivariable analyses, two independent prognostic scoring systems (PSS) were derived, one for grade ≥ 3 CRS and one for grade ≥ 3 ICANS. CRS-PSS included bulky disease, a platelet count < 150 G/L, a C-reactive protein (CRP) level > 30 mg/L and no bridging therapy or stable or progressive disease (SD/PD) after bridging. Patients with a CRS-PSS score > 2 had significantly higher risk to develop grade ≥ 3 CRS. ICANS-PSS included female sex, low level of platelets (< 150 G/L), use of axi-cel and no bridging therapy or SD/PD after bridging. Patients with a CRS-PSS score > 2 had significantly higher risk to develop grade ≥ 3 ICANS. Both scores were externally validated in international cohorts of patients treated with tisa-cel or axi-cel. 2024-10-07T08:45:31Z 2024-10-07T08:45:31Z 2024-08-06 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sesques P, Kirkwood AA, Kwon M, Rejeski K, Jain MD, Di Blasi R, et al. Novel prognostic scoring systems for severe CRS and ICANS after anti-CD19 CAR T cells in large B-cell lymphoma. J Hematol Oncol. 2024 Aug 6;17:61. 1756-8722 https://hdl.handle.net/11351/12029 10.1186/s13045-024-01579-w 39107847 001285311500002 eng Journal of Hematology & Oncology;17 https://doi.org/10.1186/s13045-024-01579-w Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf BMC Scientia