Prior antibiotics exposure predicts early and prolonged CD19 CAR T-cell-related hematologic toxicity and prognosis in acute B-cell leukemia - Summary - MDSpire
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Prior antibiotics exposure predicts early and prolonged CD19 CAR T-cell-related hematologic toxicity and prognosis in acute B-cell leukemia
To explore the correlation of prior antibiotics exposure on CAR-T cell related hematologic toxicity and develop a predictive model based on antibiotic exposure for risk assessment in R/R B-ALL patients.
Key Findings:
64.5% of patients had prior antibiotic exposure, significantly correlating with severe early hematotoxicity (P < 0.001).
High-frequency antibiotics (HF ABX) were associated with severe hematotoxicity (P = 0.009), while low-frequency antibiotics (LF ABX) showed no significant correlation (P = 0.067).
The developed score model demonstrated higher sensitivity (80%) and specificity (76.5%) compared to the CAR-HEMATOTOX model.
Patients categorized as high-risk (score ≥3) had significantly shorter median PFS (4 months vs. 11 months) and OS (6 months vs. 28 months) compared to low-risk patients.
Interpretation:
Prior exposure to HF ABX is a significant predictor of early and prolonged hematologic toxicity in R/R B-ALL patients receiving CAR-T therapy, which adversely affects prognosis.
Limitations:
The retrospective design may introduce bias, affecting the reliability of the findings.
The external validation cohort size was limited, which may impact the generalizability of the model.
Conclusion:
The antibiotic-based score model effectively identifies patients at high risk for hematologic toxicity, potentially guiding clinical decision-making in CAR-T therapy for B-ALL.
