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Endothelial Activation and Stress Index Score as a Prognostic Factor of Cytokine Release Syndrome in CAR-T Patients – A Retrospective Analysis of Multiple Myeloma and Large B-Cell Lymphoma Cohorts

Archivum Immunologiae et Therapiae Experimentalis
Volume 72 (2024): Issue 1 (January 2024)
By:
Open Access
|Sep 2024

Figures & Tables

Fig 1.

EASIX scores and lymphodepleting therapy. Patients treated with bendamustine show significantly higher EASIX values compared to Flu/CTX-treated individuals – pre-lymphodepletion and day 0 results. (A) MM/AL amyloidosis cohort and (B) LBCL cohort. AL, amyloid light-chain; EASIX, Endothelial Activation and Stress Index; Flu/CTX, fludarabine/cyclophosphamide; LBCL, large B-cell lymphoma; MM, multiple myeloma.
EASIX scores and lymphodepleting therapy. Patients treated with bendamustine show significantly higher EASIX values compared to Flu/CTX-treated individuals – pre-lymphodepletion and day 0 results. (A) MM/AL amyloidosis cohort and (B) LBCL cohort. AL, amyloid light-chain; EASIX, Endothelial Activation and Stress Index; Flu/CTX, fludarabine/cyclophosphamide; LBCL, large B-cell lymphoma; MM, multiple myeloma.

Fig 2.

Association between categorized EASIX-pre/s-EASIX-pre scores and CRS grade. (A) Jitter plot depicting the distribution of the individual CRS grade cases, divided into two groups based on EASIX-pre cutoff of 1.835. Patients with higher EASIX-pre scores (equal or above the cutoff) are more likely to experience CRS grade ≥3 (OR = 4.59, 95% CI: 1.13–21.84, p = 0.033). (B) Jitter plot depicting the distribution of the individual CRS grade cases, divided into two groups based on s-EASIX-pre cutoff of 2.134. Patients with higher s-EASIX-pre scores (equal or above the cutoff) are more likely to experience CRS grade ≥3 (OR = 4.13, 95% CI: 1.01–17.93, p = 0.01). (C) Bar chart depicting percentage of CRS grade ≥3 based on EASIX-pre cutoff of 1.835. (D) Bar chart depicting percentage of CRS grade ≥3 based on s-EASIX-pre cutoff of 2.134. CRS, cytokine release syndrome; EASIX, Endothelial Activation and Stress Index; s-EASIX, simplified EASIX.
Association between categorized EASIX-pre/s-EASIX-pre scores and CRS grade. (A) Jitter plot depicting the distribution of the individual CRS grade cases, divided into two groups based on EASIX-pre cutoff of 1.835. Patients with higher EASIX-pre scores (equal or above the cutoff) are more likely to experience CRS grade ≥3 (OR = 4.59, 95% CI: 1.13–21.84, p = 0.033). (B) Jitter plot depicting the distribution of the individual CRS grade cases, divided into two groups based on s-EASIX-pre cutoff of 2.134. Patients with higher s-EASIX-pre scores (equal or above the cutoff) are more likely to experience CRS grade ≥3 (OR = 4.13, 95% CI: 1.01–17.93, p = 0.01). (C) Bar chart depicting percentage of CRS grade ≥3 based on EASIX-pre cutoff of 1.835. (D) Bar chart depicting percentage of CRS grade ≥3 based on s-EASIX-pre cutoff of 2.134. CRS, cytokine release syndrome; EASIX, Endothelial Activation and Stress Index; s-EASIX, simplified EASIX.

Summary comparison of the cohorts

Anti-BCMA N = 69Anti-CD19 N = 65p-value
Age in years, median (range)68 (40–84)51.5 (29–89)0.915
Gender, male/female, N36/3330/350.495
Lymphodepletion regimen, N (%) 1
  Flu/CTX63 (91)59 (91)
  Bendamustine6 (9)6 (9)
CRS grade, N (%) <0.001
  08 (12)27 (43)
  I18 (26)12 (18)
  II34 (49)12 (18)
  III9 (13)12 (18)
  IV0 (0)2 (3)
EASIX score, median (range), N
  EASIX-pre1.69 (0.2–65.5); 691.24 (0.13–887.16); 610.034
  EASIX-ld1.49 (0.2–63.5); 691.1 (0.12–625.42); 580.044
  EASIX-gap1.48 (0.19–103.66); 681.17 (0.15–171.4); 580.093
  EASIX-01.38 (0.28–123.43); 641.04 (0.23–94.92); 630.059
s-EASIX score, mean (range), N
  s-EASIX-pre2.05 (0.25–53.61); 691.28 (0.27–499.52); 610.032
  s-EASIX-ld1.87 (0.2–54.5); 691.3 (0.3–392.11); 580.029
  s-EASIX-gap1.89 (0.2–64.48); 681.34 (0.35–107.46); 580.086
  s-EASIX-01.82 (0.26–51.3); 641.15 (0.45–95.71); 630.054
DOI: https://doi.org/10.2478/aite-2024-0018 | Journal eISSN: 1661-4917
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Language: English
Submitted on: May 18, 2024
Accepted on: Aug 2, 2024
Published on: Sep 14, 2024
Published by: Hirszfeld Institute of Immunology and Experimental Therapy
In partnership with: Paradigm Publishing Services
Publication frequency: 1 times per year
Keywords:
CAR-T,
Myeloma,
Lymphoma,
Endothelium,
Cytokine release syndrome
Related subjects:
Medicine,
Basic medical science,
Biochemistry,
Immunology,
Clinical medicine,
Clinical medicine, other,
Clinical chemistry

© 2024 Jaromir Tomasik, Batia Avni, Sigal Grisariu, Shlomo Elias, Eran Zimran, Polina Stepensky, Grzegorz W. Basak, published by Hirszfeld Institute of Immunology and Experimental Therapy
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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