دورية أكاديمية
Transient acute kidney injury after chimeric antigen receptor T-cell therapy in patients with hematological malignancies
العنوان: | Transient acute kidney injury after chimeric antigen receptor T-cell therapy in patients with hematological malignancies |
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المؤلفون: | León-Román, Juan, Bolufer Cardona, Monica, Sánchez-Salinas, Mario, Alonso-Martínez, Carla, Bestard, Oriol, IACOBONI, GLORIA, Bermejo García, Sheila, Cecilia del Carmen, Carpio Segura, Garcia-Carro, Clara, Barba, Pere, Soler, María José |
المساهمون: | Institut Català de la Salut, León-Román J, Bermejo S, Bolufer M, Bestard O, Soler MJ Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CSUR National Unit of Expertise for Complex Glomerular Diseases of Spain, Barcelona, Spain. Iacoboni G Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Carpio C, Sánchez-Salinas M, Barba P Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. García-Carro C Nephrology Department, San Carlos Clinical University Hospital, Madrid, Spain. Alonso-Martínez C Servei de Farmàcia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
المصدر: | Scientia |
بيانات النشر: | Oxford University Press |
سنة النشر: | 2024 |
مصطلحات موضوعية: | Cèl·lules T - Ús terapèutic, Sang - Malalties - Tractament, Ronyons - Malalties - Complicacions, DISEASES::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Acute Kidney Injury, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Biological Therapy::Cell- and Tissue-Based Therapy, CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Membrane Proteins::Receptors, Cell Surface::Receptors, Artificial::Receptors, Chimeric Antigen, DISEASES::Neoplasms::Neoplasms by Site::Hematologic Neoplasms, ENFERMEDADES::enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales::insuficiencia renal::lesión renal aguda, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapia biológica::tratamientos basados en células y tejidos, COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas de membranas::receptores de superficie celular::receptores artificiales::receptores de antígenos quiméricos, ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias hematológicas |
الوصف: | CAR-T therapy; Acute kidney injury; Onconephrology ; Terapia CAR-T; Lesión renal aguda; Onconefrología ; Teràpia CAR-T; Lesió renal aguda; Onconefrologia ; Background Acute kidney injury (AKI) occurs in 30% of patients infused with chimeric antigen receptor (CAR) T-cells. The purpose of this study was to identify risk factors and long-term outcomes after AKI in patients who received CAR T-cell therapy. Methods Medical records of 115 adult patients with R/R hematological malignancies treated with CD19-targeted CAR T-cells at Vall d'Hebron University Hospital between July 2018 and May 2021. Baseline demographic data including age, gender, ethnicity, body mass index (BMI), and co-morbidities, as well as the type of hematological neoplasia and prior lines of therapy were collected. Laboratory parameters including serum creatinine and whole blood hemoglobin were retrospectively reviewed and values were gathered for days +1, +7, +14, +21, and +28 post-infusion. Results A total of 24/115 (21%) patients developed AKI related to CAR T-cell therapy; 6/24 with AKI over chronic kidney disease (CKD). Two patients had AKI in the context of lymphodepleting (LD) chemotherapy and the other 22 after CAR T-cell infusion, starting at day+1 in 3 patients, day+7 in 13 patients, day +14 in 1 patient, day+21 in 2 patients, and day+28 in 3 patients. Renal function was recovered in 19/24 (79%) patients within the first month after infusion. Male gender, CKD, cytokine release syndrome (CRS), and immune effector cell-associated neurotoxicity syndrome (ICANS) were associated with AKI. Male gender, CKD, ICANS grade ≥3 and CRS grade ≥2 were identified as independent risk factors for AKI on multivariable analysis. In terms of the most frequent CAR T-cell related complications, CRS was observed in 95 (82%) patients and ICANS in 33 (29%) patients. Steroids were required in 34 (30%) patients and tocilizumab in 37 (32%) patients. Six (5%) patients were admitted to the intensive care unit (1 for septic shock, 4 for CRS grade ≥2 associated to ICANS ... |
نوع الوثيقة: | article in journal/newspaper |
وصف الملف: | application/pdf |
اللغة: | English |
تدمد: | 2048-8513 |
العلاقة: | Clinical Kidney Journal;17(3); https://doi.org/10.1093/ckj/sfae027Test; info:eu-repo/grantAgreement/ES/PEICTI2021-2023/PI21%2F01292; info:eu-repo/grantAgreement/ES/PEICTI2021-2023/AC22%2F00029; info:eu-repo/grantAgreement/ES/PEICTI2021-2023/RD21%2F0005%2F0016; León-Román J, Iacoboni G, Bermejo S, Carpio C, Bolufer M, García-Carro C, et al. Transient acute kidney injury after chimeric antigen receptor T-cell therapy in patients with hematological malignancies. Clin Kidney J. 2024 Mar;17(3):27.; https://hdl.handle.net/11351/11224Test |
DOI: | 10.1093/ckj/sfae027 |
الإتاحة: | https://doi.org/10.1093/ckj/sfae027Test https://hdl.handle.net/11351/11224Test |
حقوق: | Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0Test/ ; info:eu-repo/semantics/openAccess |
رقم الانضمام: | edsbas.3B3C2C9 |
قاعدة البيانات: | BASE |
تدمد: | 20488513 |
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DOI: | 10.1093/ckj/sfae027 |