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12.01.2024 | Original Article

Modified EASIX scores predict severe CRS/ICANS in patients with acute myeloid leukemia following CLL1 CAR-T cell therapy

verfasst von: Yifan Zhao, Xiaomei Zhang, Meng Zhang, Ruiting Guo, Yi Zhang, Yedi Pu, Haibo Zhu, Pengjiang Liu, Yu Zhang, Xiaoyuan He, Cuicui Lyu, Hairong Lyu, Xia Xiao, Mingfeng Zhao

Erschienen in: Annals of Hematology | Ausgabe 3/2024

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Abstract

Chimeric antigen receptor T (CAR-T) cell therapy targeting CLL1 has been considered a potent weapon for patients with acute myeloid leukemia (AML). This study aims to evaluate the efficacy and toxicity of CLL1 CAR-T cell therapy in a larger cohort, with particular attention to cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Among the 32 patients assessed for efficacy, complete remission occurred in 71.88% (23/32) of cases and undetectable minimal residual disease in 14 patients. The CRS developed in all patients, with 8 individuals experiencing ICANS. Severe CRS and ICANS were observed in 11 and 2 patients, respectively. Furthermore, the Endothelial Activation and Stress Index (EASIX) and its derivatives measured before and after CLL1 CAR-T cell infusion were employed for predicting the severe complications. Significant differences were observed in EASIX scores on the day before lymphodepletion (Day BL, P = 0.023), −1 (P < 0.001), +1 (P < 0.001), and +3(P = 0.014); sEASIX scores on Day BL (P = 0.007), −1 (P < 0.001), +1 (P < 0.001), and +3 (P < 0.001); and mEASIX score on Day −1 (P = 0.004) between patients with mild and severe CRS/ICANS. Additionally, there was a significant difference in mEASIX scores between responders and non-responders on Day BL (P = 0.004) and Day −1 (P = 0.044). Our findings indicate that pre- and post-infusion assessments of EASIX/mEASIX/sEASIX scores serve as reliable prognostic indicators for severe CRS/ICANS and treatment response following CLL1 CAR-T cell therapy, which can assist physicians in implementing preemptive treatment strategies for potential severe complications and screening patients who are suitable candidates for CLL1 CAR-T cell therapy. EASIX/mEASIX/sEASIX scores serve as reliable prognostic indicators for severe CRS/ICANS following CLL1 CAR-T cell therapy. The preinfusion mEASIX scores of CLL1 CAR-T cells can effectively predict treatment response.

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Titel: Modified EASIX scores predict severe CRS/ICANS in patients with acute myeloid leukemia following CLL1 CAR-T cell therapy
verfasst von: Yifan Zhao
Xiaomei Zhang
Meng Zhang
Ruiting Guo
Yi Zhang
Yedi Pu
Haibo Zhu
Pengjiang Liu
Yu Zhang
Xiaoyuan He
Cuicui Lyu
Hairong Lyu
Xia Xiao
Mingfeng Zhao
Publikationsdatum: 12.01.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Annals of Hematology / Ausgabe 3/2024
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-024-05617-y

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Modified EASIX scores predict severe CRS/ICANS in patients with acute myeloid leukemia following CLL1 CAR-T cell therapy

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