ArticleBlood advances2023
A validated composite comorbidity index predicts outcomes of CAR T-cell therapy in patients with diffuse large B-cell lymphoma.
Article in Blood advances, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- A systematic review and meta-analysis of nonrelapse mortality after CAR T cell therapy.Nature medicine · 2024Pooled it
- Predictive Models for Toxicities after CAR T-cell Therapy: Challenges and Opportunities.Blood cancer discovery · 2026Review
- Review
- Impact of age on outcomes after CD19 CAR T-cell therapy for large B-cell lymphomas.Blood neoplasia · 2026Article
- New comorbidity index associated with survival after chimeric antigen receptor T-cell therapy for large B-cell lymphoma.Blood advances · 2026Article
- Clinical determinants of survival outcomes and acute toxicity after adoptive cellular therapy for solid tumors.Frontiers in immunology · 2026Article
- Predictive markers for the efficacy of CAR T-cell therapy: the interplay between CAR T-cell fitness and systemic immunity.Blood advances · 2025Review
- Prognostic implications of adverse events associated with CAR-T cell therapy: a population-based global observational study.EClinicalMedicine · 2025Article
- Endothelial dysfunction and proinflammatory state determine severe hematotoxicity and inferior outcome of CAR-T therapy.HemaSphere · 2025Article
- Predictors of response to CD19 chimeric antigen receptor T-cell therapy in large B-cell lymphoma: a consolidated review.Current opinion in oncology · 2025Review
- Prophylactic Tocilizumab prior to infusion of CD19 CAR T-cells reduces therapy-related complications in older lymphoma patients.Annals of hematology · 2025Article
- Frail is not fail: Limited impact of comorbidities on non-relapse mortality and safety in patients with LBCL treated with CAR-T.British journal of haematology · 2025Article
- CAR-T cell therapy in older adults with relapsed/refractory LBCL: benefits and challenges.Journal for immunotherapy of cancer · 2025Review
- MYC networks associate with decreased CD8 T-cell presence in diffuse large B-cell lymphoma and may be addressed by the synergistic combination of AZD4573 and Selinexor - a preliminary analysis.Annals of hematology · 2025Article
- Evolving strategies for addressing CAR T-cell toxicities.Cancer metastasis reviews · 2024Review
- Several factors that predict the outcome of large B-cell lymphoma patients who relapse/progress after chimeric antigen receptor (CAR) T-cell therapy can be identified before cell administration.Cancer medicine · 2024Article
- Biomarkers of outcome in patients undergoing CD19 CAR-T therapy for large B cell lymphoma.HemaSphere · 2024Review
- Optimization of older adults by a geriatric assessment-guided multidisciplinary clinic before CAR T-cell therapy.Blood advances · 2024Article
- Article
- Biomarkers for prediction of CAR T therapy outcomes: current and future perspectives.Frontiers in immunology · 2024Review
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Authors and funding
23 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chimeric antigen receptor T-cell therapy (CART) has extended survival of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). However, limited durability of response and prevalent toxicities remain problematic. Identifying patients who are at high risk of disease progression, toxicity, and death would inform treatment decisions. Although the cumulative illness rating scale (CIRS) has been shown to correlate with survival in B-cell malignancies, no prognostic score has been independently validated in CART recipients. We retrospectively identified 577 patients with relapsed/refractory DLBCL indicated for CART at 9 academic centers to form a learning cohort (LC). Random survival forest modeling of overall survival (OS) and progression-free survival (PFS) was performed to determine the most influential CIRS organ systems and severity grades. The presence of a severe comorbidity (CIRS score ≥ 3) in the respiratory, upper gastrointestinal, hepatic, or renal system, herein termed "Severe4," had the greatest impact on post-CART survival. Controlling for other prognostic factors (number of prior therapies, Eastern Cooperative Oncology Group performance status, BCL6 translocation, and molecular subtype), Severe4 was strongly associated with shorter PFS and OS in the LC and in an independent single-center validation cohort (VC). Severe4 was also a significant predictor of grade ≥3 cytokine release syndrome in the LC, while maintaining this trend in the VC. Thus, our results indicate that adverse outcomes for patients with DLBCL meant to receive CART can be predicted using a simplified CIRS-derived comorbidity index.
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