Late Events After CD-19 CAR-T Treatment

Hossain, Nasheed; Nishimura, Michael I.

doi:10.1016/j.bbmt.2019.10.020

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…Acute toxicities are more well documented, and in fact, both cytokine release syndrome (CRS) and neurotoxicity, both of which have proved to have serious and/or life-threatening consequences, have received significant attention [ 12 ]. CRS is a spectrum of clinical and laboratory findings of fevers, hypotension, hypoxia and neurologic changes associated with substantial elevations of serum cytokine levels.…”

Section: Introductionmentioning

confidence: 99%

Patient-reported outcome (PRO) instruments used in patients undergoing adoptive cell therapy (ACT) for the treatment of cancer: a systematic review

Taylor,

Law,

Coomber-Moore

et al. 2023

Syst Rev

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Introduction Adoptive cell therapy (ACT) is a rapidly evolving field. Patient-reported outcomes (PROs) allow patients to report the impact of treatment on their quality of life during and after treatment. The systematic review aims to characterise the breadth of PROs utilised in ACT cancer care and provide guidance for the use of PROs in this patient population in the future. Methods A systematic search was conducted (MEDLINE, PsycINFO, Embase and CINAHL) in August 2021 by two reviewers. Search terms covered the following: “adoptive cell therapy”, “patient-reported outcomes” and “cancer”. Studies were included if they used a PRO measure to report the impact of ACT. The methodological quality of PROs was assessed. Forward and backward reference searching was conducted of any relevant papers. A quality grading scale was applied based on Cochrane and Revenson criteria for classification of high-quality studies. Key data from the studies and the included PROs was extracted by two researchers and tabulated. Results One-hundred nine papers were identified; 11 papers were included. The majority of studies were single-arm trials or observational studies. Twenty-two different PROs were identified; none was ACT specific. The PROMIS-29 and EQ-5D were most commonly used. Few studies collected PRO data in the first 1–2 weeks. Four studies followed patients up for over a year, and a further four studies followed patients for approximately 3 months. Discussion None of the PROs identified have been designed specifically for ACT. Appropriateness of existing instruments should be considered. It should be considered whether it is appropriate to collect data more frequently in the acute stage and then less frequently during follow-up. It should be considered if one tool is suitable at all time points or if the tool should be adapted depending on time since treatment. More research is needed to identify the exact timings of PRO assessments, and qualitative work with patients is needed to determine the most important issues for them throughout the treatment and follow-up.

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Section: Introductionmentioning

confidence: 99%

Patient-reported outcome (PRO) instruments used in patients undergoing adoptive cell therapy (ACT) for the treatment of cancer: a systematic review

Taylor,

Law,

Coomber-Moore

et al. 2023

Syst Rev

View full text Add to dashboard Cite

show abstract

“…Although high response rate has generated enthusiasm, more remains to be learned about the potential toxicities and effects on organ function [12][13][14][15][16]. This is especially true given the increased utilization since the US Food and Drug Administration approved axicabtagene ciloleucel for B cell lymphomas and tisagenlecleucel for B cell acute lymphoblastic leukemia and B cell lymphomas in 2017.…”

Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury after CAR-T Cell Therapy: Low Incidence and Rapid Recovery

Gutgarts

Jain

Zheng

et al. 2020

Biology of Blood and Marrow Transplantation

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Chimeric antigen receptor (CAR) T cell therapy using engineered cytotoxic T cells has shown promising responses in various hematologic malignancies. Cytokine release syndrome (CRS) and immune effector cell-associated neurologic syndrome (ICANS) are recognized toxicities of CAR-T, whereas kidney injury remains less well recognized. The objective of the present study was to identify the incidence of acute kidney injury (AKI) after CAR-T cell therapy, potential risk factors, and recovery of kidney function. We performed a retrospective review of 46 adult patients with non-Hodgkin lymphoma treated with CAR-T therapy between February 2018 and February 2019 at our institution. Serum creatinine values before CAR-T therapy through day 100 were used to assess AKI, as defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria: grade 1, 1.5-to <2-fold of baseline; grade 2, 2-to <3-fold of baseline; grade 3, 3-fold of baseline. CRS and ICANS were graded using the consensus criteria of the American Society of Transplantation and Cellular Therapy. The overall incidence of CRS was 78.3% (95% confidence interval [CI], 66% to 90.5%), of whom 13% (95% CI, 3.3% to 22.8%) developed grade 3-4 CRS, whereas the overall incidence of ICANS was lower at 45.7% (95% CI, 3.1% to 60.3%). The cumulative incidence of any grade AKI by day 100 was 30% (95% CI, 16.9% to 43.9%), with a grade 1 AKI incidence of 21.7% (95% CI, 9.7% to 33.8%) and a grade 2-3 AKI incidence of 8.7% (95% CI, .4% to 17%). No patients developed severe AKI necessitating renal replacement therapy. Patients with previous autologous or allogeneic stem cell transplantation, those requiring intensive care unit level care and with grade 3-4 CRS had a higher incidence of AKI. Most patients recovered, with kidney function returning to baseline within 30 days. We conclude that with early recognition and management of CAR-T complications, the incidence of AKI is low, the severity of injury is mild, and most patients recover kidney function within 30 days.

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Late Events After CD-19 CAR-T Treatment

Cited by 2 publications

References 21 publications

Patient-reported outcome (PRO) instruments used in patients undergoing adoptive cell therapy (ACT) for the treatment of cancer: a systematic review

Patient-reported outcome (PRO) instruments used in patients undergoing adoptive cell therapy (ACT) for the treatment of cancer: a systematic review

Acute Kidney Injury after CAR-T Cell Therapy: Low Incidence and Rapid Recovery

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