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Abstract: SA-PO160

AKI and Chimeric Antigen Receptor T Cell Therapy in Hematologic Neoplasms

Session Information

Category: Onconephrology

  • 1600 Onconephrology

Authors

  • León Román, Juan Carlos, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
  • Iacoboni, Gloria, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
  • Bermejo, Sheila, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
  • Carpio, Cecilia, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
  • Bolufer, Mónica, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
  • Bestard, Oriol, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
  • Barba, Pere, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
  • Soler, Maria Jose, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
Background

CAR-T cell is a treatment for refractory hematologic malignancies(RHM). AKI occurs between 20-30% after infusion. The purpose of this study was to identify risk factors for AKI and long-term outcomes

Methods

Medical records of 115 patients treated with CD19-targeted CAR-T cells for RHM at HUVH between July 2018 and May 2021 were reviewed. Clinical data was reviewed within 60 days after CAR-T cells therapy. We performed statistically analysis to identify risk factors for AKI and mortality

Results

24/115 patients presented AKI after therapy. AKI was diagnosed: day+1 in 3 patients, day+7 in 13 patients, day+14 in 1 patient, day+21 in 2 patients, day+28 in 2 patients, day+60 in 1 patient, and 2 patients in conditioning therapy. 19 patients recovered kidney function within the first month. The most frequent hematological neoplasm was diffuse large B-cell lymphoma(90.5%). Investigational product was infused in 27.8%, tisagenlecleucel in 49.6%, axicabtagen ciloleucelin in 20%, and brexucabtagene autoleucel in 2.6%. The most frequent complications were CRS(72.2%), febrile neutropenia(67%) and neurotoxicity(16.5%). 3/36 patients died after CAR-T infusion. Male sex, type of CAR-T cell therapy, neurotoxicity, calcium levels at day+21 and +28, phosphorus levels at day+1 and +28, and albumin levels at day+7 and +21 were associated with AKI. Only male sex(p=0.03) and neurotoxicity(p=0.02) were identified as independent risk factors for AKI. Gender, neurotoxicity, and creatinine showed no significant differences for mortality after one-year follow-up

Conclusion

AKI is frequent but mild disease with a fast recovery in patients treated with CAR-T