Does Cytokine Release Syndrome Predict Cancer Remission within 30 Days Following Chimeric Antigen Receptor T-Cell Therapy?

Purpose:

This study aims to investigate whether Cytokine Release Syndrome (CRS) following Chimeric Antigen Receptor T-cell (CAR-T) therapy in patients with relapsed or refractory large B-cell lymphoma (LBCL) and mantle cell lymphoma, predicts cancer remission/response within 30 days. Remission was defined as a Deauville score of 3 or below, 30 days post-therapy.

Method:

This retrospective, single-center study included patients aged ≥18 years with (LBCL) and mantle cell lymphoma who underwent apheresis between 2019 and 2023 for (CAR-T) therapy at one academic medical center in the United States. Patients were categorized based on the presence of (CRS) following CAR-T therapy, regardless of grade. Statistical analyses, including chi-squared and Wilcoxon Mann-Whitney U tests, were conducted to compare remission rates between CRS and non-CRS groups. Additionally, Firth's penalized logistic regression was used due to the small sample size.

Results:

The study included 32 patients, with 81.25% (26/32) experiencing (CRS). There was no statistically significant relationship indicating an association between the onset of CRS and achieving a response on the day 30 PET scan. This lack of significance might be due to the small sample size and imbalance between CRS and non-CRS groups. However, there was a notable trend indicating that patients with CRS had higher remission rates (73.08%) compared to those without CRS (50%), although the effect was not statistically significant (p=0.272).

Conclusions:

The preliminary findings suggest that while CRS may correlate with higher remission rates post-CAR-T therapy, the small sample size limits definitive conclusions. Future research should focus on larger cohorts and consider the severity of CRS to better understand its predictive value for remission.

No relevant conflicts of interest to declare.