EEG-based grading of immune effector cell-associated neurotoxicity syndrome.

Autor:	Jones DK; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA. Djones51@mgh.harvard.edu.; Harvard Medical School, Boston, MA, USA. Djones51@mgh.harvard.edu.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA. Djones51@mgh.harvard.edu.; Brigham Young University, Provo, UT, USA. Djones51@mgh.harvard.edu., Eckhardt CA; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA. CECKHARDT@PARTNERS.ORG.; Harvard Medical School, Boston, MA, USA. CECKHARDT@PARTNERS.ORG.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA. CECKHARDT@PARTNERS.ORG.; Department of Neurology, Brigham and Women's Hospital (MGH), Boston, MA, USA. CECKHARDT@PARTNERS.ORG., Sun H; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Tesh RA; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Malik P; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Quadri S; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Firme MS; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., van Sleuwen M; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Jain A; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Fan Z; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Jing J; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Ge W; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Nascimento FA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA., Sheikh IS; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Jacobson C; Department of Neurology, Brigham and Women's Hospital (MGH), Boston, MA, USA.; Dana Farber Cancer Institute (DFCI), Boston, MA, USA., Frigault M; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Dana Farber Cancer Institute (DFCI), Boston, MA, USA., Kimchi EY; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Cash SS; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Lee JW; Harvard Medical School, Boston, MA, USA.; Department of Neurology, Brigham and Women's Hospital (MGH), Boston, MA, USA., Dietrich J; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Dana Farber Cancer Institute (DFCI), Boston, MA, USA., Westover MB; Department of Neurology, Massachusetts General Hospital (MGH), 50 Staniford St. Suite 401, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA.; MGH Cancer Center for Brain Health, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Scientific reports [Sci Rep] 2022 Nov 21; Vol. 12 (1), pp. 20011. Date of Electronic Publication: 2022 Nov 21.
DOI:	10.1038/s41598-022-24010-1
Abstrakt:	CAR-T cell therapy is an effective cancer therapy for multiple refractory/relapsed hematologic malignancies but is associated with substantial toxicity, including Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS). Improved detection and assessment of ICANS could improve management and allow greater utilization of CAR-T cell therapy, however, an objective, specific biomarker has not been identified. We hypothesized that the severity of ICANS can be quantified based on patterns of abnormal brain activity seen in electroencephalography (EEG) signals. We conducted a retrospective observational study of 120 CAR-T cell therapy patients who had received EEG monitoring. We determined a daily ICANS grade for each patient through chart review. We used visually assessed EEG features and machine learning techniques to develop the Visual EEG-Immune Effector Cell Associated Neurotoxicity Syndrome (VE-ICANS) score and assessed the association between VE-ICANS and ICANS. We also used it to determine the significance and relative importance of the EEG features. We developed the Visual EEG-ICANS (VE-ICANS) grading scale, a grading scale with a physiological basis that has a strong correlation to ICANS severity (R = 0.58 [0.47-0.66]) and excellent discrimination measured via area under the receiver operator curve (AUC = 0.91 for ICANS ≥ 2). This scale shows promise as a biomarker for ICANS which could help to improve clinical care through greater accuracy in assessing ICANS severity. (© 2022. The Author(s).)
Databáze:	MEDLINE
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