C-reactive protein and ferritin levels and length of intensive care unit stay in patients with B-cell lymphomas treated with axicabtagene ciloleucel

Autor: Pramod Guru, Megan Melody, James M. Foran, Allison C. Rosenthal, Paula A Lengerke Diaz, Nicole Gannon, Mohamed A. Kharfan-Dabaja, Ernesto Ayala, Hemant S. Murthy, Vivek Roy, Hollie Saunders, Zaid Abdel Rahman, Han W. Tun, Januario E. Castro
Rok vydání: 2020
Předmět:
Male
Immunotherapy
Adoptive
law.invention
0302 clinical medicine
law
RC254-282
biology
CAR T cell
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Hematology
General Medicine
Middle Aged
Prognosis
Intensive care unit
Hospitalization
Cytokine release syndrome
Intensive Care Units
medicine.anatomical_structure
C-Reactive Protein
Oncology
030220 oncology & carcinogenesis
Toxicity
Axicabtagene ciloleucel
Female
CRP
Adult
medicine.medical_specialty
Lymphoma
B-Cell
Antigens
CD19
03 medical and health sciences
Young Adult
Refractory
Internal medicine
Statistical significance
medicine
Humans
Diseases of the blood and blood-forming organs
B cell
Aged
Retrospective Studies
Ferritin
Biological Products
business.industry
C-reactive protein
medicine.disease
DLBCL
Ferritins
biology.protein
RC633-647.5
business
030215 immunology
Zdroj: Hematology/Oncology and Stem Cell Therapy, Vol 14, Iss 2, Pp 141-146 (2021)
ISSN: 2589-0646
Popis: Objective/Background Chimeric antigen receptor (CAR) T-cell is an effective therapy in relapsed/refractory large B-cell lymphomas that, due to its unique toxicities, often requires escalation of care to the intensive care unit (ICU) setting. C-reactive protein (CRP) and ferritin are serum inflammatory markers associated with onset and persistence of CAR T-cell-related toxicity. Methods We retrospectively analyzed 34 patients treated with axicabtagene ciloleucel (axi-cel) who were divided into two groups: patients requiring admission to the ICU during initial hospitalization (n = 13, 38%) and those who did not (n = 21, 62%). Primary objective was to examine possible relationships between serum ferritin and/or CRP levels with the need for, and length of, ICU stay between these groups. Results All 13 patients admitted to the ICU developed cytokine release syndrome (CRS) and 11 of them also developed neurotoxicity (NT). Of the 21 patients in the non-ICU group, 18 developed CRS and 5 patients developed NT. Grade of CRS and NT were higher in ICU versus non-ICU patients (p = .03 and .001, respectively). There was no correlation between CRP levels at time of ICU admission and length of ICU stay (correlation of 0.41, p = .17). Yet, there was an association between serum ferritin levels and length of ICU stay (R2 = 0.73) which did not reach statistical significance (correlation of 0.21, p = .49). Conclusion Notwithstanding the limitations of the small sample size, our study suggests that an elevated ferritin level at the time of escalation of medical care may be possibly indicative of anticipated prolonged ICU hospitalization in patients treated with axi-cel. A large multicenter study is certainly needed to confirm this observation.
Databáze: OpenAIRE
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