Low utility of the H-Score and HLH-2004 criteria to identify patients with secondary hemophagocytic lymphohistiocytosis after CAR-T cell therapy for relapsed/refractory diffuse large B-Cell lymphoma

Autor: Dong Won Kim, Ali Bukhari, Forat Lutfi, Facundo Zafforoni, Fikru Merechi, Moaath K. Mustafa Ali, David Gottlieb, Seung T. Lee, Mehmet H. Kocoglu, Nancy M. Hardy, Jean Yared, Aaron P. Rapoport, Saurabh Dahiya, Jennie Y. Law
Rok vydání: 2022
Předmět:
Zdroj: Leukemia & Lymphoma. 63:1339-1347
ISSN: 1029-2403
1042-8194
Popis: Secondary hemophagocytic lymphohistiocytosis (HLH) is a life-threatening immune dysregulation disorder. Use of chimeric antigen receptor T-cell therapy (CAR-T) is associated with cytokine release syndrome (CRS), Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS) and secondary HLH. However, application of HLH scoring systems (H-score, HLH-2004 criteria) are not validated in this setting. We analyzed the utility of applying the H-score and the HLH-2004 criteria to identify patients with possible HLH post-CAR-T for Relapsed/Refractory Diffuse Large B-cell Lymphoma. Only two of four patients with post CAR-T HLH met five or more of the diagnostic criteria for HLH by HLH 2004 criteria. In contrast all four post CAR-T HLH patients had a high H-score (169); however, an additional ten patients that did not have HLH also had a high H-score. Thus, in this patient population, both scoring systems were demonstrated to have low prognostic significance in differentiating between high grade CRS and HLH.
Databáze: OpenAIRE
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