ArticleAnnals of hematology2026
Δ-β2M as a dynamic biomarker for predicting ICU admission after CAR T-cell therapy.
Article in Annals of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
CAR T-cell therapy is associated with life-threatening toxicities requiring intensive care unit (ICU) admission. Reliable biomarkers for early risk stratification are lacking. We evaluated Δ-β2-microglobulin (Δ-β2M) as a dynamic biomarker for predicting ICU admission after CAR T-cell therapy. Single-center retrospective study with a derivation cohort (2020-2023, n = 97) and two temporally independent validation cohorts (2024, n = 38; 2025, n = 23). Δ-β2M was calculated as the change between infusion (T2) and day +3 (T3). Primary endpoint was ICU admission. Predictive performance was assessed using receiver operating characteristic (ROC) analysis, calibration (Hosmer-Lemeshow test, Brier score), and decision curve analysis. Complete Δ-β2M data were available in 54 (derivation), 17 (2024), and 17 (2025) patients. Δ-β2M demonstrated consistent discrimination for ICU admission across all cohorts (derivation AUC 0.67; 2024 AUC 0.70; 2025 AUC 0.82), but not for immune effector cell associated neurotoxicity syndrome (ICANS) (AUC 0.53). The model showed good calibration (Hosmer-Lemeshow p = 0.073; Brier score 0.232), confirmed by cross-validation (Brier score 0.236). Decision curve analysis revealed positive net benefit across clinically relevant thresholds (0.20-0.70). Baseline parameters (albumin, CRP, NT-proBNP) lacked consistent validation. Δ-β2M is an easily measurable dynamic biomarker associated with ICU admission after CAR T-cell therapy, with good calibration and clinical utility. These findings support further evaluation of early biomarker kinetics in toxicity risk prediction models.
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