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  1. Home
  3. Endothelial Activation And Stress Index Score As A Prognostic Factor Of Cytokine Release Syndrome In Car-t Patients - A Retrospective Analysis Of Multiple Myeloma And Large B-cell Lymphoma Cohorts.
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Endothelial Activation And Stress Index Score As A Prognostic Factor Of Cytokine Release Syndrome In Car-t Patients - A Retrospective Analysis Of Multiple Myeloma And Large B-cell Lymphoma Cohorts.

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Endothelial Activation and Stress Index Score as a Prognostic Factor of Cytokine Release Syndrome in CAR-T Patients -

Jaromir Tomasik1, Batia Avni2, Sigal Grisariu2

  • 1Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

Archivum Immunologiae Et Therapiae Experimentalis
|September 15, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

The Endothelial Activation and Stress Index (EASIX) score does not predict severe cytokine release syndrome (CRS) in multiple myeloma/light-chain amyloidosis patients undergoing CAR-T therapy. However, it showed potential for predicting CRS in large B-cell lymphoma patients, though significance was lost upon validation.

Keywords:
CAR-TCytokine release syndromeEndotheliumLymphomaMyeloma

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Area of Science:

  • Hematology
  • Oncology
  • Immunotherapy

Background:

  • Endothelial Activation and Stress Index (EASIX) is a proposed prognostic factor for adverse events in hematological malignancies.
  • Endothelial dysfunction is linked to complications after stem cell transplantation and CAR-T therapy.
  • Cytokine release syndrome (CRS) is a significant adverse event following CAR-T therapy.

Purpose of the Study:

  • To evaluate the prognostic utility of EASIX and simplified EASIX (s-EASIX) scores for predicting grade ≥3 CRS in patients with multiple myeloma/light-chain amyloidosis (MM/AL amyloidosis) and large B-cell lymphoma (LBCL) undergoing CAR-T therapy.

Main Methods:

  • Retrospective cohort study involving MM/AL amyloidosis (N=69) and LBCL (N=65) patients.
  • EASIX and s-EASIX scores were calculated at four time points pre-CAR-T infusion.
  • Primary endpoint was the occurrence of CRS grade ≥3.

Main Results:

  • In MM/AL amyloidosis, neither EASIX nor s-EASIX scores predicted grade ≥3 CRS.
  • In LBCL, pre-lymphodepletion EASIX and s-EASIX scores were initially associated with grade ≥3 CRS (OR=1.06, OR=1.05).
  • Internal validation with bootstrapping negated the predictive significance of EASIX and s-EASIX scores in LBCL.

Conclusions:

  • EASIX scores are not effective predictors of CRS in MM/AL amyloidosis CAR-T therapy.
  • While initially promising for LBCL CAR-T patients, EASIX scores ultimately failed to reliably predict grade ≥3 CRS after validation.