Recovery-model: A model for CAR T-cell-related thrombocytopenia in relapsed/refractory multiple myeloma

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2023-07-01 Epub Date: 2023-05-22 DOI:10.1016/j.thromres.2023.05.016

Zhe Li , Yimei Que , Di Wang , Jie Lu , Chunhui Li , Menglei Xu , Zhiqiong Wang , Qiuxia Yu , Xiaolu Long , Ning An , Yi Xiao , Chunrui Li

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引用次数: 0

Abstract

Background

Patients with multiple myeloma (MM) treated with anti-B cell maturation antigen (BCMA) and chimeric antigen receptor (CAR) T-cell therapy tend to show delayed platelet recovery.

Patients and methods

This single-center retrospective observational study included a cohort of patients with MM treated with anti-BCMA CAR-T cells in ChiCTR-OPC-16009113, ChiCTR1800018137, and ChiCTR1900021153.

Results

Fifty-eight patients with MM treated with anti-BCMA CAR-T cells were included. Delayed platelet recovery (platelet count not recovering to 50 × 10⁹/L within 28 days) was observed in 36 % of patients. Regression analysis identified several factors that influenced platelet recovery, and accordingly, a Recovery-Model was developed. A high Recovery-Model score indicates a greater risk of delayed platelet recovery after CAR-T cell infusion and reflects the risk of hematologic toxicity. The model's predictive biomarkers included baseline platelet count, baseline hemoglobin level, logarithm of baseline Ferritin level, and cytokine release syndrome grade. Finally, survival analysis showed a significant relationship between overall survival, delayed platelet recovery (p = 0.0457), and a high Recovery-Model score (p = 0.0011).

Conclusions

Inflammation-related factors and bone marrow reserves are associated with delayed platelet recovery. Therefore, we developed a model to predict the risk of delayed platelet recovery and hematological toxicity in relapsed/refractory patients with MM after anti-BCMA CAR-T cell treatment.

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康复模型:复发/难治性多发性骨髓瘤中CAR - t细胞相关血小板减少的模型

背景用抗B细胞成熟抗原（BCMA）和嵌合抗原受体（CAR）T细胞治疗的多发性骨髓瘤（MM）患者往往表现出血小板恢复延迟。患者和方法本单中心回顾性观察性研究纳入了一组用ChiCTR-OPC-16009113、ChiCTR1800018137和ChiCTR1900021153中的抗BCMA CAR-T细胞治疗的MM患者。36%的患者观察到血小板恢复延迟（血小板计数在28天内未恢复到50×109/L）。回归分析确定了影响血小板回收的几个因素，并据此建立了回收模型。高恢复模型评分表明CAR-T细胞输注后血小板恢复延迟的风险更大，并反映了血液学毒性的风险。该模型的预测生物标志物包括基线血小板计数、基线血红蛋白水平、基线铁蛋白水平的对数和细胞因子释放综合征分级。最后，生存率分析显示，总生存率、血小板恢复延迟（p=0.0457）和高恢复模型评分（p=0.0011）之间存在显著关系。结论炎症相关因素和骨髓储备与血小板恢复延迟有关。因此，我们开发了一个模型来预测抗BCMA CAR-T细胞治疗后复发/难治性MM患者血小板恢复延迟和血液学毒性的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.