Cancer cachexia and weight loss prior to CAR T-cell therapy for lymphoma are independently associated with poor outcomes.

Autor:	Valtis YK; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Devlin SM; Memorial Sloan-Kettering Cancer Center, New York, New York, United States., Shouval R; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Rejeski K; Adult BMT and Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States., Corona M; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Luna De Abia A; Hospital Universitario Ramón y Cajal, Spain., Rivas-Delgado A; Memorial Sloan Kettering Cancer Center, United States., Luttwak E; Memorial Sloan Kettering Cancer Center, NYC, New York, United States., Cassanello G; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Landego I Dr; University of Manitoba, Winnipeg, Canada., Schöder H; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Bedmutha A; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Boardman AP; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Shah GL; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Scordo M; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Perales MA; Hospital Universitario Ramón y Cajal, Spain., Salles GA; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Palomba ML; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Shah UA; Weill Cornell Medical College, United States., Park JH; Memorial Sloan-Kettering Cancer Center, New York, New York, United States.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2024 Oct 29. Date of Electronic Publication: 2024 Oct 29.
DOI:	10.1182/bloodadvances.2024014555
Abstrakt:	CAR T-cell therapy has transformed the care of lymphoma, yet many patients relapse. Several prognostic markers have been associated with CAR T cell outcomes, such as tumor burden, response to bridging chemotherapy, and laboratory parameters at the time of lymphodepletion or infusion. The effect of cancer cachexia and weight loss prior to CAR T cells on toxicity and outcomes is not well understood. Here, we present a retrospective single institution cohort study of 259 patients with lymphoma treated with CAR T-cells between 2017 and 2023. We observed that patients with a >5% decrease in their body mass index (BMI) in the 3 months preceding CAR T treatment (weight loss group; all meeting one of the commonly accepted definitions of cancer cachexia) had higher disease burden and inflammatory parameters (CRP, ferritin, IL6, TNFa) at time of lymphodepletion and CAR T-cell infusion. Patients with weight loss experienced higher rates of grade 3+ neurotoxicity and early hematotoxicity but those effects were not seen upon multivariable adjustment. However, in both univariate and multivariable analysis, patients with weight loss had worse response rates, overall survival, and event-free survival, indicating that weight loss is an independent poor prognostic factor. Our data suggest that weight loss in the 3 months preceding CAR T-cell therapy represents a worrisome "alarm signal" and potentially modifiable factor alongside tumor burden and inflammation and warrants further investigation in patients treated with CAR T therapy. (Copyright © 2024 American Society of Hematology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu