2022
DOI: 10.2139/ssrn.4172074
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Chimeric Antigen Receptor T-Cell-Associated Hemophagocytic Lymphohistiocytosis (carHLH) Predicts Poor Survival with Real-World Use of Tisagenlecleucel for B-ALL

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Cited by 2 publications
(1 citation statement)
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“…Kennedy et al studied the emergence of post-BCMA CAR T MAS, defined as a ferritin increase ≥100 µg/L/h within a 24-h period and a minimum fibrinogen <150 mg/dL or maximum LDH >2 times the upper limit of normal within 14 days following CAR T and found a 22% incidence rate [ 164 ]. Several publications have confirmed these findings with other CAR T products in ALL, NHL, and multiple myeloma, with an estimated median onset of around 2 weeks after CAR T infusion but with generally poorer outcomes, including up to 67% mortality [ 165 , 166 , 167 , 168 ]. An ASTCT working group is expected to publish consensus criteria for IEC-HS soon, which may rely on a combination of elevated or rapidly rising ferritin; worsening inflammation after resolving, resolved, or treatment-refractory CRS; transaminase elevations; hypofibrinogenemia; hemophagocytosis; and worsening cytopenias, in addition to minor criteria assessing fever, neurotoxicity, pulmonary injury, renal insufficiency, hypertriglyceridemia, splenomegaly, hyperbilirubinemia, coagulopathy, and LDH elevations.…”
Section: Special Populations and Treatment-related Hlhmentioning
confidence: 77%
“…Kennedy et al studied the emergence of post-BCMA CAR T MAS, defined as a ferritin increase ≥100 µg/L/h within a 24-h period and a minimum fibrinogen <150 mg/dL or maximum LDH >2 times the upper limit of normal within 14 days following CAR T and found a 22% incidence rate [ 164 ]. Several publications have confirmed these findings with other CAR T products in ALL, NHL, and multiple myeloma, with an estimated median onset of around 2 weeks after CAR T infusion but with generally poorer outcomes, including up to 67% mortality [ 165 , 166 , 167 , 168 ]. An ASTCT working group is expected to publish consensus criteria for IEC-HS soon, which may rely on a combination of elevated or rapidly rising ferritin; worsening inflammation after resolving, resolved, or treatment-refractory CRS; transaminase elevations; hypofibrinogenemia; hemophagocytosis; and worsening cytopenias, in addition to minor criteria assessing fever, neurotoxicity, pulmonary injury, renal insufficiency, hypertriglyceridemia, splenomegaly, hyperbilirubinemia, coagulopathy, and LDH elevations.…”
Section: Special Populations and Treatment-related Hlhmentioning
confidence: 77%