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Open Access 09-10-2023 | CAR T-Cell Therapy | Original Article

IL-10 plus the EASIX score predict bleeding events after anti-CD19 CAR T-cell therapy

Authors: Xindi Wang, Chenggong Li, Wenjing Luo, Yinqiang Zhang, Zhongpei Huang, Jia Xu, Heng Mei, Yu Hu

Published in: Annals of Hematology | Issue 12/2023

Abstract

Chimeric antigen receptor (CAR) T-cell-associated coagulopathy can cause bleeding events. To explore risk factors for hemorrhage after CAR T-cell therapy, we retrospectively analyzed routine indicators in 56 patients with non-Hodgkin lymphoma and B-cell acute lymphoblastic leukemia who received anti-CD19 CAR T-cell therapy. Disturbance of coagulation occurred mainly within one month post infusion, especially on day 7 and 14. The cumulative incidence of bleeding events within one month was 32.8%, with the median onset of 7 (range, 0–28) days. All bleeding events were grade 1–3. Patients who experienced bleeding events within one month had longer prothrombin time, higher IL-6, higher IL-10, and lower platelets before lymphodepletion. There were also correlations among coagulation-, inflammatory-, and tumor burden-related markers. Multi-variate analysis showed IL-10 (> 7.98 pg/mL; adjusted odds ratio [OR], 13.84; 95% confidence interval [CI], 2.03–94.36; P = 0.007) and the endothelial activation and stress index (EASIX, defined as dehydrogenase [U/L] × creatinine [mg/dL] / platelets [×10⁹ cells/L]; >7.65; adjusted OR, 7.06; 95% CI, 1.03–48.23; P = 0.046) were significant risk factors for bleeding events. IL-10 plus the EASIX defined three risk groups for bleeding events with cumulative incidence of 100% (hazard ratio [HR], 14.47; 95% CI, 2.78–75.29; P < 0.0001), 38.5% (HR, 3.68; 95% CI, 0.82–16.67; P = 0.089), and 11.8% (reference), respectively. Future studies are needed to verify the risk assessment models for bleeding events after CAR T-cell treatment in larger cohorts.

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Title: IL-10 plus the EASIX score predict bleeding events after anti-CD19 CAR T-cell therapy
Authors: Xindi Wang
Chenggong Li
Wenjing Luo
Yinqiang Zhang
Zhongpei Huang
Jia Xu
Heng Mei
Yu Hu
Publication date: 09-10-2023
Publisher: Springer Berlin Heidelberg
Keywords: CAR T-Cell Therapy
Non-Hodgkin Lymphoma
Published in: Annals of Hematology / Issue 12/2023
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-023-05477-y

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