Table 2.
Characteristics of CAR-T recipients in ICU studies
| Characteristics and variables | CAR-ICU study [65] | CARTTAS study [66] | Hospital-wide study [67] |
|---|---|---|---|
| Inclusion period | November 2017–May 2019 | February 2018–February 2020 | July 2017–December 2020 |
| Type of study | Retrospective, cohort, multicentre study | Retrospective, cohort, multicentre international study | Retrospective, cohort, monocentre study |
| Nature of B cell malignancies | DLBCL, FL | DLBCL, FL, MM, ALL | DLBCL, ALL, MM |
| Nature of CAR-T cell therapy | Axicabtagene ciloleucel, Tisagenlecleucel | NA | Autologous CAR-T cells, Axicabtagene ciloleucel, Tisagenlecleucel, Brexucabtagene autoleucel, bb2121, Allogenic CAR-T cells (UCART19) |
| Lines of chemotherapy prior to CAR, median (range) | 4 [1–11] | 3 [2–4] | 3 [3, 4] |
| Number of patients treated by CAR-T cell therapy | 345 | 942 | NA |
| Number of patients admitted to ICU, n (%) | 120 (34.8) | 258 (27.4) | 71 |
| Age, year, mean (SD) or median [range] | 57 (15) | 58 [43–66] | 60 [37–67.5] |
| Sex (male), n (%) | 79 (65.7) | 144 (60) | 42 (59) |
| Maximum SOFA score, median [range] | 5 [1–21] | 4 [2–7] | 4 [2–6] |
| Number of patients with TLS, n (%) | NA | NA | NA |
| Number of patients with CRS, n (%) | 81 (67.5) | 200 (77.5) | 33 (46) |
| Grade 3–4 CRS, n (%) | 28 (34.6) | 50 (19.4) | 6 (18.1) |
| Time from infusion to maximum CRS, day (range) | 5 [0–42] | NA | 2 [1–3] |
| Number of patients with ICANS, n (%) | 89 (74.2) | 108 (41.5) | 26 (37) |
| Grade 3–4 ICANS, n (%) | 67 (75.3) | 38 (14.7) | 8 (30) |
| Time from infusion to maximum ICANS, day (range) | 6 [2–74] | NA | 1 [0–1] |
| Documented infections, n (%) | 26 (21.6) | 78 (30.2) | 21 (30) |
| Documented cardiomyopathy, n (%) | 3 (2.5) | NA | NA |
| Documented sHLH, n (%) | 4 (3.3) | NA | NA |
| Documented acute renal failure, n (%) | 8 (6.7) | NA | NA |
| Organ support | |||
| Vasopressors, n (%) | 22 (18.3) | 74 (28.7) | 20 (28) |
| High-flow oxygen therapy, n (%) | 11 (9.2) | 14 (5.4) | NA |
| Non-invasive ventilation, n (%) | 2 (1.7) | 0 (0) | 4 (6) |
| Invasive mechanical ventilation, n (%) | 14 (11.7) | 26 (10) | |
| Renal replacement therapy, n (%) | 3 (2.5) | 12 (4.6) | 1 (1.5) |
| Treatment of toxicities | |||
| Tocilizumab, n (%) | 87 (72.5) | 166 (64.3) | 49 (69) |
| Corticosteroid, n (%) | 93 (77.5) | 155 (60) | 40 (56) |
| Siltuximab treatment, n (%) | 9 (7.5) | NA | 9 (12.6) |
| Anakinra treatment, n (%) | 9 (7.5) | NA | 2 (2.8) |
| Outcome | |||
| ICU length of stay, day (range) | 4 [1–22] | 4 [1–10] | NA |
| ICU mortality, n (%) | 11 (9) | 14 (5.4) | 1 (1.5) |
| Hospital length of stay, day (range) | 24 [5–180] | 16 [9–34] | NA |
| Hospital mortality, n (%) | 21 (17.5) | 36 (14) | 8 (12) |
DLBCL diffuse large B cell lymphoma, FL follicular lymphoma, MM multiple myeloma, ALL acute lymphoblastic leukaemia, CAR-T chimeric antigen receptor T cell, SOFA Sepsis-related Organ Failure Assessment, CRS cytokine release syndrome, ICANS Immune effector Cells Associated Neurotoxicity Syndrome, sHLH Secondary Haemophagocytic Lymphohistiocytosis Syndrome, TLS Tumour Lysis Syndrome, NA not applicable
Results are expressed as number (percentage), mean (standard deviation) or median [range]