Baseline and early post-treatment clinical and laboratory factors associated with severe neurotoxicity following 19-28z CAR T cells in adult patients with relapsed B-ALL.

• DOI: 10.1200/jco.2017.35.15_suppl.7024
• Publication Date: 2018-09-06T15:50:36Z
• Authors: Jae Hong Park; Bianca Santomasso; Isabelle Riviere; Brigitte Senechal; Xiuyan Wang; Terence Purdon; Yongzeng Wang; Elizabeth Halton; Claudia Diamonte; Daniel Li; Michel Sadelain; Renier J. Brentjens
• Keywords: Cytokine Release Syndrome

7024 Background: CD19-specific chimeric antigen receptor (CAR) modified T cells produce high anti-tumor activity in relapsed or refractory (R/R) ALL, but can be associated with cytokine release syndrome (CRS) and neurotoxicity (NTX). Herein, we report baseline post-treatment clinical laboratory factors severe NTX (≥Grade 3) our phase I trial of 19-28z CAR for adult patients (pts) R/R B-ALL (NCT01044069). Methods: 51 pts were treated following conditioning chemotherapy at MSKCC. In order to identify serum biomarkers (sNTX), examined demographic, treatment, blood parameters as well vivo expansion cytokines, performed univariate multivariate analysis. Results: this cohort ALL pts, 20, 8, 2, 18 3 experienced Gr 0, 1, 3, 4 NTX, respectively. No pt developed grade 5 NTX. Disease burden (≥50% blasts) the time cell infusion (p = 0.0045) ≥Gr3 CRS 0.0010) significantly sNTX, found no association age, weight, dose, choice (Flu/Cy s. Cy), prior lines treatment. Among parameters, fever, low PLT, ferritin MCHC elevated GM-CSF, IFNγ, IL-15, IL-5, IL-10, IL-2 day sNTX (all p < 0.01). While some these cytokines also cases, IL-5 unique sNTX. Furthermore, peak 7 0.0001) correlated Lastly, analysis revealed PLT 60 > 33.2% morphologic disease ( 5% has 95% sensitivity 70% specificity identifying pts. Conclusions: These data provide a characterization early receiving should help appropriate intervention strategy mitigate Clinical information: NCT01044069.