| المساهمون: |
Institut Català de la Salut, [Rejeski K] Department of Medicine III, Hematology and Oncology, University Hospital, LMU Munich, Munich, Germany. Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany. German Cancer Consortium (DKTK) Munich Site, and German Cancer Research Center, Heidelberg, Germany. [Perez A] Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA. Blood & Marrow Transplant Program, Miami Cancer Institute, Miami, Florida, USA. [Iacoboni G, Carpio C, Barba P] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Departament de Medicina, Universitat Autònoma of Barcelona, Bellaterra, Spain. [Penack O] Department of Hematology, Oncology and Tumorimmunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. German Cancer Consortium (DKTK) Berlin Site, and German Cancer Research Center, Heidelberg, Germany. [Bücklein V] Department of Medicine III, Hematology and Oncology, University Hospital, LMU Munich, Munich, Germany. Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany. [Jentzsch L] Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany, Vall d'Hebron Barcelona Hospital Campus |
| الوصف: |
Hematologic neoplasms; Receptors; Chimeric antigen Neoplasias hematológicas; Receptores; Antígeno quimérico Neoplàsies hematològiques; Receptors; Antigen quimèric Background CD19-directed chimeric antigen receptor T-cell therapy (CAR-T) represents a promising treatment modality for an increasing number of B-cell malignancies. However, prolonged cytopenias and infections substantially contribute to the toxicity burden of CAR-T. The recently developed CAR-HEMATOTOX (HT) score—composed of five pre-lymphodepletion variables (eg, absolute neutrophil count, platelet count, hemoglobin, C-reactive protein, ferritin)—enables risk stratification of hematological toxicity. Methods In this multicenter retrospective analysis, we characterized early infection events (days 0–90) and clinical outcomes in 248 patients receiving standard-of-care CD19 CAR-T for relapsed/refractory large B-cell lymphoma. This included a derivation cohort (cohort A, 179 patients) and a second independent validation cohort (cohort B, 69 patients). Cumulative incidence curves were calculated for all-grade, grade ≥3, and specific infection subtypes. Clinical outcomes were studied via Kaplan-Meier estimates. Results In a multivariate analysis adjusted for other baseline features, the HT score identified patients at high risk for severe infections (adjusted HR 6.4, 95% CI 3.1 to 13.1). HThigh patients more frequently developed severe infections (40% vs 8%, p |
