Kidney Week

Abstract: SA-PO1252

Long-Term Evolution of Kidney Function After Chimeric Antigen Receptor (CAR)-T Cell Therapy Infusion in Patients with Relapsed/Refractory Hematological Malignancies (R/RHM)

Session Information

• Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1600 Onconephrology

Authors

• Orelogio, Abel Andrés, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Abel Andrés Orelogio, MD

• Patricio-Liébana, Marc, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Marc Patricio-Liébana, MD

• Iacoboni, Gloria, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Gloria Iacoboni, MD

• Bermejo Garcia, Sheila, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Sheila Bermejo Garcia, MD, DrMed, PhD

• Nunez-Delgado, Sara, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Sara Nunez-Delgado, MD

• Ramos, Natalia, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Natalia Ramos, MD, PhD

• Toapanta Gaibor, Nestor Gabriel, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Nestor Gabriel Toapanta Gaibor, MD

• Barba, Pere, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Pere Barba, MD

• Soler, Maria Jose, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Maria Jose Soler, MD, PhD

• León-Román, Juan Carlos, Vall d'Hebron Institut de Recerca, Barcelona, CT, Spain

Juan Carlos León-Román, MD

Background

CART-cells therapy has revolutionized treatment of R/R HM. AKI occurs in up to 30% of patients after infusion. Its long-term impact remains unknown.

Methods

We retrospectively reviewed the medical records of 332 patients treated with CART-cell between July 2018 and December 2024. Only patients alive with complete remission at 2years post-infusion were included. We analyzed blood samples collected within the first 14 days after infusion, as well as at 1 year and 2years of follow-up. We divided the initial cohort into two groups: patients who developed AKI after infusion and those who did not.

Results

65/332 patients were included. Of the 267 excluded, 169 died and 98 survived. Among the 65 patients, mean age was 55.4±12.9years, and males predominated(61%). Hypertension was present in23%, diabetes in4.6%, and established CKD in3%. The most common hematologic neoplasms:large B-cell lymphoma(75.4%) and mantle cell lymphoma(9.2%). The most frequently utilized CART-cells constructs were axicabtagene ciloleucel(40%) and an investigational product(21.5%). Seventeen patients(17/65) developed AKI: 15/17 de novo and 2/17 on CKD. No significant differences were observed in CRS(29.5% vs 70.5%) or ICANS(31.6% vs 68.4%) between the AKI and non-AKI groups. Steroids were required in 24 and tocilizumab in 23 patients. Significant differences in renal function were found between groups, mainly attributable to the inclusion of two patients with CKD in the AKI group. After the first month, 11/17achieved recovery of baseline renal function. Only 3patients had persistent deterioration: 2with de novo AKI and one with AKI on CKD. Table2 indicates that although the AKI group started with higher creatinine levels, with a creatinine peak during the first two weeks after CAR T-cells infusion, a progressive decline was observed without reaching baseline values.

Conclusion

AKI is relatively common; however, it is usually mild and resolves rapidly. Patients who develop AKI show worse kidney function after two years of follow-up.