The grade of cytokine release syndrome (CRS) following chimeric antigen receptor T-cell (CAR-T) therapy was found to be negatively correlated with albumin and total cholesterol after infusion. These findings were published in Supportive Care in Cancer.
CAR-T therapy has become a promising option for patients with hematologic malignancies, however, adverse events such as CRS continue to be a challenge. As CAR-T therapy is a newer therapeutic option, no study to date has evaluated the role of nutritional status in CAR-T outcomes.
For this study, 117 patients enrolled in a phase 1/2 clinical trial for CAR-T conducted in 2018-2020 were retrospectively reviewed for changes in nutritional status following CAR-T infusion and adverse outcomes.
Patients were median age 53 years (range, 14 to 74); 56.4% were boys or men; BMI was 22.5±2.8 kg/m2; 55 (47.0%) had multiple myeloma, 39 (33.3%) had acute leukemia, and 23 (19.7%) had lymphoma; and 33 (28.2%) had a history of hematopoietic stem cell transplantation.
At 7 days after CAR-T, mean difference in serum albumin was -3.84 mg/L (P <.001), a significant decrease. By days 14 and 21, no significant differences were observed compared with baseline.
Serum total cholesterol was significantly decreased at days 7 (mean difference [MD], -0.85 mmol/L; P <.001), 14 (MD, -0.79 mmol/L; P <.001), and 21 (MD, -0.47 mmol/L; P <.001) compared with baseline.
CRS grade 2, 3, or 4 were observed among 40.1% (47), 23.9% (28), and 5.1% (6) of patients, respectively. CRS was observed to be negatively correlated with serum albumin at days 7 (r, -0.353; P <.001) and 14 (r, -0.292; P =.003) and total cholesterol at all time points (r range, -0.395 to -0.216; all P ≤.025).
This study was limited by its short follow-up duration.
These data implied that risk for CRS after CAR-T may be associated with nutritional status, indicating that additional screening may be required to decrease rates of adverse events.
Ding S, Cai L, Jin A, et al. Nutritional status alterations after chimeric antigen receptor T cell therapy in patients with hematological malignancies: a retrospective study. Support Care Cancer. Published online January 5, 2022. doi:10.1007/s00520-021-06639-2