Shouse G, Kaempf A, Gordon MJ, et al. A Validated Composite Comorbidity Index Predicts Outcomes of CAR T-Cell Therapy in Patients with Diffuse Large B Cell Lymphoma. Blood Advances. 2023; (doi: 10.1182/bloodadvances.2022009309).
Use of a simplified cumulative illness rating scale (CIRS)-derived comorbidity index can predict negative outcomes from chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). The retrospective study placed 577 patients with relapsed/refractory DLBCL designated for CAR T-cell treatment into a learning cohort (LC). Using random survival forest modeling, a severe comorbidity (CIRS score ≥3) in the respiratory, upper gastrointestinal, hepatic, or renal system — called "Severe4" — was identified as the most significant factor for post-CAR-T survival in the LC and in an independent single-center validation cohort (VC) (N=218), Severe4 strongly correlated with shorter overall survival and progression-free survival. It was also predictive of grade >3 cytokine release syndrome in both the LC and VC, the researchers report.