A multicenter, retrospective analysis suggests that the Cumulative Illness Rating Scale (CIRS) has potential as a prognostic tool in evaluating patients undergoing chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). The study’s results were presented at the 61st American Society of Hematology (ASH) Annual Meeting & Exposition, held in Orlando, Florida.1

In this analysis, researchers evaluated several factors to determine effects on overall survival (OS) and progression-free survival (PFS) in patients (N=59) with R/R DLBCL. Comorbidities were assessed using CIRS scores and Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) scores.

The median study follow-up time was 154 days. In 40 patients, the total CIRS score was 7 or higher, and 29 patients showed a CIRS score of 3 to 4 in at least 1 organ system (CIRS-3+).


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In univariate analyses, differences in OS and PFS were apparent for patients when stratified by CIRS scores. Median OS for patients with a total CIRS score of 7 or higher or with CIRS-3+ was 237 days. For patients with lower CIRS scores or without CIRS-3+, median OS was 305 days (hazard ratio [HR], 5.31; P =.025).

Median PFS for patients with a total CIRS scores of 7 or higher or with CIRS-3+ was 170 days, and for remaining patients, the median PFS was not reached (HR, 3.65; P =.037). HCT-CI scores of 3 or higher revealed no significant relationships with OS or PFS.

In multivariate analyses, CIRS severity continued to show significant associations with both OS (adjusted HR, 15.44; P =.042) and PFS (adjusted HR, 8.64; P =.002).

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The investigators stated that these results suggest comorbidities may need to be taken into account when assessing patients with R/R DLBCL for CAR-T therapy.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.

Reference

Kittai AS, Gordon MJ, Mian A, et al. Comorbidities predict inferior survival in patients receiving CAR T-cell therapy for relapsed/refractory DLBCL: a multicenter retrospective analysis. Oral presentation at: 61st ASH Annual Meeting & Exposition; December 7-10, 2019; Orlando, FL; Abstract 780.