PMID- 34264268
OWN - NLM
STAT- MEDLINE
DCOM- 20210723
LR  - 20230917
IS  - 2473-9537 (Electronic)
IS  - 2473-9529 (Print)
IS  - 2473-9529 (Linking)
VI  - 5
IP  - 14
DP  - 2021 Jul 27
TI  - CRP and ferritin in addition to the EASIX score predict CAR-T-related toxicity.
PG  - 2799-2806
LID - 10.1182/bloodadvances.2021004575 [doi]
AB  - The Endothelial Activation and Stress Index (EASIX) score, defined as 
      [(creatinine x lactate dehydrogenase [LDH])/platelets], is a marker of 
      endothelial activation that has been validated in the allogeneic hematopoietic 
      stem cell transplant setting. Endothelial activation is one of the mechanisms 
      driving immune-mediated toxicities in patients treated with chimeric antigen 
      receptor-T (CAR-T)-cell therapy. This study's objective was to evaluate the 
      association between EASIX and other laboratory parameters collected before 
      lymphodepletion and the subsequent onset of cytokine release syndrome (CRS) and 
      immune effector cell-associated neurotoxicity syndrome (ICANS) those patients. 
      Toxicity data were collected prospectively on 171 patients treated with 
      axicabtagene ciloleucel (axi-cel) for large B-cell lymphoma (LBCL). CRS grades 2 
      to 4 were diagnosed in 81 (47%) patients and ICANS grades 2 to 4 in 84 (49%). 
      EASIX combined with ferritin (EASIX-F) identified 3 risk groups with CRS grades 2 
      to 4 cumulative incidence of 74% (hazards ratio [HR], 4.8; 95% confidence 
      interval [CI], 2.1-11; P < .001), 49% (HR, 2.3; 95% CI, 1.02-5; P = .04), and 23% 
      (reference), respectively. EASIX combined with CRP and ferritin (EASIX-FC) 
      identified 3 risk groups with an ICANS grade 2 to 4 cumulative incidence of 74% 
      (HR, 3.6; 95% CI, 1.9-6.9; P < .001), 51% (HR, 2.1; 95% CI, 1.1-3.9; P = .025), 
      and 29% (reference). Our results indicate that common laboratory parameters 
      before lymphodepletion correlate with CAR-T-related toxicities and can help 
      support clinical decisions, such as preemptive toxicity management, 
      hospitalization length, and proper setting for CAR-T administration.
CI  - (c) 2021 by The American Society of Hematology.
FAU - Greenbaum, Uri
AU  - Greenbaum U
AUID- ORCID: 0000-0002-8582-4572
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Strati, Paolo
AU  - Strati P
AD  - Department of Lymphoma and Myeloma.
AD  - Department of Translational Molecular Pathology.
FAU - Saliba, Rima M
AU  - Saliba RM
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Torres, Janet
AU  - Torres J
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Rondon, Gabriela
AU  - Rondon G
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Nieto, Yago
AU  - Nieto Y
AUID- ORCID: 0000-0001-6034-8939
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Hosing, Chitra
AU  - Hosing C
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Srour, Samer A
AU  - Srour SA
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Westin, Jason
AU  - Westin J
AUID- ORCID: 0000-0002-1824-2337
AD  - Department of Lymphoma and Myeloma.
FAU - Fayad, Luis E
AU  - Fayad LE
AD  - Department of Lymphoma and Myeloma.
FAU - Lee, Hun J
AU  - Lee HJ
AD  - Department of Lymphoma and Myeloma.
FAU - Iyer, Swaminathan P
AU  - Iyer SP
AD  - Department of Lymphoma and Myeloma.
FAU - Nair, Ranjit
AU  - Nair R
AD  - Department of Lymphoma and Myeloma.
FAU - Nastoupil, Loretta J
AU  - Nastoupil LJ
AD  - Department of Lymphoma and Myeloma.
FAU - Parmar, Simrit
AU  - Parmar S
AD  - Department of Lymphoma and Myeloma.
FAU - Rodriguez, Maria A
AU  - Rodriguez MA
AUID- ORCID: 0000-0002-3564-8697
AD  - Department of Lymphoma and Myeloma.
FAU - Samaniego, Felipe
AU  - Samaniego F
AD  - Department of Lymphoma and Myeloma.
FAU - Steiner, Raphael E
AU  - Steiner RE
AUID- ORCID: 0000-0003-3717-3629
AD  - Department of Lymphoma and Myeloma.
FAU - Wang, Michael
AU  - Wang M
AUID- ORCID: 0000-0001-9748-5486
AD  - Department of Lymphoma and Myeloma.
FAU - Pinnix, Chelsea C
AU  - Pinnix CC
AD  - Department of Radiation Oncology, and.
FAU - Flowers, Christopher R
AU  - Flowers CR
AD  - Department of Lymphoma and Myeloma.
FAU - Tummala, Sudhakar
AU  - Tummala S
AD  - Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Ramdial, Jeremy L
AU  - Ramdial JL
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Yalniz, Fevzi F
AU  - Yalniz FF
AUID- ORCID: 0000-0003-3569-8632
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Hawkins, Misha
AU  - Hawkins M
AD  - Department of Lymphoma and Myeloma.
FAU - Rezvani, Katayoun
AU  - Rezvani K
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Champlin, Richard E
AU  - Champlin RE
AUID- ORCID: 0000-0002-4314-5037
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Shpall, Elizabeth J
AU  - Shpall EJ
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Neelapu, Sattva S
AU  - Neelapu SS
AUID- ORCID: 0000-0003-1045-4914
AD  - Department of Lymphoma and Myeloma.
FAU - Kebriaei, Partow
AU  - Kebriaei P
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
FAU - Ahmed, Sairah
AU  - Ahmed S
AUID- ORCID: 0000-0001-7302-8299
AD  - Department of Stem Cell Transplantation and Cellular Therapy.
AD  - Department of Lymphoma and Myeloma.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Blood Adv
JT  - Blood advances
JID - 101698425
RN  - 0 (Receptors, Chimeric Antigen)
RN  - 9007-73-2 (Ferritins)
SB  - IM
MH  - Cytokine Release Syndrome
MH  - Ferritins
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - *Lymphoma, Large B-Cell, Diffuse
MH  - *Receptors, Chimeric Antigen
PMC - PMC8341350
EDAT- 2021/07/16 06:00
MHDA- 2021/07/24 06:00
PMCR- 2021/07/15
CRDT- 2021/07/15 12:17
PHST- 2021/02/22 00:00 [received]
PHST- 2021/04/20 00:00 [accepted]
PHST- 2021/07/15 12:17 [entrez]
PHST- 2021/07/16 06:00 [pubmed]
PHST- 2021/07/24 06:00 [medline]
PHST- 2021/07/15 00:00 [pmc-release]
AID - S2473-9529(21)00365-7 [pii]
AID - 2021/ADV2021004575 [pii]
AID - 10.1182/bloodadvances.2021004575 [doi]
PST - ppublish
SO  - Blood Adv. 2021 Jul 27;5(14):2799-2806. doi: 10.1182/bloodadvances.2021004575.