Hematologic toxicity frequently complicates chimeric antigen receptor (CAR) T-cell therapy, resulting in significant morbidity and mortality. In an effort to standardize reporting, the European Hematology Association (EHA) and European Society of Blood and Marrow Transplantation (EBMT) devised the immune effector cell-associated hematotoxicity (ICAHT) grading system, distinguishing between early (day 0-30) and late (after day +30) events based on neutropenia depth and duration. However, manual implementation of ICAHT grading criteria is time-consuming and susceptible to subjectivity and error. To address these challenges, we introduce a novel computational approach, utilizing the R programming language, to automate early and late ICAHT grading. Given the complexities of early ICAHT grading, we benchmarked our approach both manually and computationally in two independent cohorts totaling 1251 patients. Our computational approach offers significant implications by streamlining grading processes, reducing manual time and effort, and promoting standardization across varied clinical settings. We provide this tool to the scientific community alongside a comprehensive implementation guide, fostering its widespread adoption and enhancing reporting consistency for ICAHT.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380036PMC
http://dx.doi.org/10.1038/s41409-024-02278-3DOI Listing

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  • - Immune effector cell-associated hematotoxicity (ICAHT) is a common toxicity linked to CAR T-cell therapy, notably affecting patients with various lymphomas and multiple myeloma, but has not been previously studied in B-cell acute lymphoblastic leukemia (B-ALL).
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  • Eltrombopag, a thrombopoietin receptor agonist, was evaluated in a study involving 38 patients from 10 hospitals in Spain who developed platelet transfusion dependence after CAR-T treatment.
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Hematologic toxicity frequently complicates chimeric antigen receptor (CAR) T-cell therapy, resulting in significant morbidity and mortality. In an effort to standardize reporting, the European Hematology Association (EHA) and European Society of Blood and Marrow Transplantation (EBMT) devised the immune effector cell-associated hematotoxicity (ICAHT) grading system, distinguishing between early (day 0-30) and late (after day +30) events based on neutropenia depth and duration. However, manual implementation of ICAHT grading criteria is time-consuming and susceptible to subjectivity and error.

View Article and Find Full Text PDF

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