دورية أكاديمية
Identifying Early Infections in the Setting of CRS With Routine and Exploratory Serum Proteomics and the HT10 Score Following CD19 CAR-T for Relapsed/Refractory B-NHL
| العنوان: | Identifying Early Infections in the Setting of CRS With Routine and Exploratory Serum Proteomics and the HT10 Score Following CD19 CAR-T for Relapsed/Refractory B-NHL |
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| المؤلفون: | Blumenberg, Viktoria, Iacoboni García-Calvo, Gloria, Kharboutli, Soraya, Hernani, Rafael, Barba Suñol, Pere, Lopez Corral, Lucia, Rejeski, Kai |
| المساهمون: | Institut Català de la Salut, Rejeski K, Blumenberg V Department of Medicine III – Hematology/Oncology, University Hospital, LMU 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. Bavarian Cancer Research Center (BZKF), Partner Sites Munich and Erlangen, Germany. Iacoboni G, Barba P Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Departament of Medicina, Universitat Autònoma of Barcelona, Bellaterra, Spain. Lopez-Corral L Hematology Department, Hospital Clínico Universitario de Salamanca, IBSAL, CIBERONC, Salamanca, Spain. Centro de Investigación del Cáncer-IBMCC, Salamanca, Spain. Kharboutli S Bavarian Cancer Research Center (BZKF), Partner Sites Munich and Erlangen, Germany. Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Germany. Hernani R Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain, Vall d'Hebron Barcelona Hospital Campus |
| المصدر: | Scientia |
| بيانات النشر: | Wolters Kluwer Health |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Cèl·lules B - Tumors - Tractament, Cèl·lules T - Receptors, ANATOMY::Cells::Blood Cells::Leukocytes::Leukocytes, Mononuclear::Lymphocytes::T-Lymphocytes, CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Membrane Proteins::Receptors, Cell Surface::Receptors, Artificial::Receptors, Chimeric Antigen, DISEASES::Neoplasms::Neoplasms by Histologic Type::Lymphoma::Lymphoma, Non-Hodgkin::Lymphoma, B-Cell::Lymphoma, Large B-Cell, Diffuse, Other subheadings::Other subheadings::/therapy, ANATOMÍA::células::células sanguíneas::leucocitos::leucocitos mononucleares::linfocitos::linfocitos T, 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 tipo histológico::linfoma::linfoma no Hodgkin::linfoma de células B::linfoma de células B grandes difuso, Otros calificadores::Otros calificadores::/terapia |
| الوصف: | Infections; Serum proteomics ; Infeccions; Proteòmica sèrica ; Infecciones; Proteómica sérica ; Early fever after chimeric antigen receptor T-cell (CAR-T) therapy can reflect both an infection or cytokine release syndrome (CRS). Identifying early infections in the setting of CRS and neutropenia represents an unresolved clinical challenge. In this retrospective observational analysis, early fever events (day 0–30) were characterized as infection versus CRS in 62 patients treated with standard-of-care CD19.CAR-T for relapsed/refractory B-cell non-Hodgkin lymphoma. Routine serum inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6], procalcitonin [PCT]) were recorded daily. Exploratory plasma proteomics were performed longitudinally in 52 patients using a multiplex proximity extension assay (Olink proteomics). Compared with the CRSonly cohort, we noted increased event-day IL-6 (median 2243 versus 64 pg/mL, P = 0.03) and particularly high PCT levels (median 1.6 versus 0.3 µg/L, P < 0.0001) in the patients that developed severe infections. For PCT, an optimal discriminatory threshold of 1.5 µg/L was established (area under the receiver operating characteristic curve [AUCROC] = 0.78). Next, we incorporated day-of-fever PCT levels with the patient-individual CAR-HEMATOTOX score. In a multicenter validation cohort (n = 125), we confirmed the discriminatory capacity of this so-called HT10 score for early infections at first fever (AUCROC = 0.87, P < 0.0001, sens. 86%, spec. 86%). Additionally, Olink proteomics revealed pronounced immune dysregulation and endothelial dysfunction in patients with severe infections as evidenced by an increased ANGPT2/1 ratio and an altered CD40/CD40L-axis. In conclusion, the high discriminatory capacity of the HT10 score for infections highlights the advantage of dynamic risk assessment and supports the incorporation of PCT into routine inflammatory panels. Candidate markers from Olink proteomics may further refine risk-stratification. If validated prospectively, the ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2572-9241 |
| العلاقة: | HemaSphere;7(4); http://dx.doi.org/10.1097/HS9.0000000000000858Test; Rejeski K, Blumenberg V, Iacoboni G, Lopez-Corral L, Kharboutli S, Hernani R, et al. Identifying Early Infections in the Setting of CRS With Routine and Exploratory Serum Proteomics and the HT10 Score Following CD19 CAR-T for Relapsed/Refractory B-NHL. HemaSphere. 2023 Apr;7(4):e858.; https://hdl.handle.net/11351/9433Test |
| DOI: | 10.1097/HS9.0000000000000858 |
| الإتاحة: | https://doi.org/10.1097/HS9.0000000000000858Test https://hdl.handle.net/11351/9433Test |
| حقوق: | Attribution-NonCommercial-ShareAlike 4.0 International ; http://creativecommons.org/licenses/by-nc-sa/4.0Test/ ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.A7295E43 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 25729241 |
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| DOI: | 10.1097/HS9.0000000000000858 |