Table 1.
Patient, laboratory, and clinical characteristics for patients who developed MAS-L vs patients who did not
| N or median (% or range) | |||
|---|---|---|---|
| MAS-L (n = 12) | No MAS-L (n = 43) | P | |
| Patient characteristics | |||
| Median age, y | 64.1 (43.3-74.2) | 62.4 (33.7-77.3) | .87 |
| Female | 3 (25%) | 25 (58.1%) | .06 |
| Type of MM | |||
| IgA-K | 2 (16.7%) | 8 (18.6%) | .94 |
| IgA-L | 0 (0%) | 2 (4.7%) | |
| IgD-K | 0 (0%) | 1 (2.3%) | |
| IgG-K | 6 (66.7%) | 21 (48.9%) | |
| IgG-L | 1 (8.3%) | 7 (16.3%) | |
| LC-K | 1 (8.3%) | 4 (9.3%) | |
| High-risk cytogenetics* | 8 (66.7%) | 30 (69.8%) | 1.0 |
| Baseline % BM plasma cells | 40 (0- 95) | 25 (0-100) | .62 |
| Baseline FLC, K/L ratio | 176 (1.5-1311) | 203.2 (2.2-11 054) | .62 |
| Baseline M-protein, g/dL | 2.6 (0-4.8) | 1.4 (0-6.2) | .22 |
| Median prior lines of treatment | 6 (4-13) | 5 (1-12) | .09 |
| Use of bridging chemotherapy | 8 (66.7%) | 27 (62.8%) | 1.0 |
| Median infused CART dose (×106 cells) | 300 (47.3-600) | 300 (41.8-600) | .05 |
| Infection before CART therapy† | 9 (75%) | 4 (9.3%) | <.001 |
| Time from infection to CART, d | 18 (8-29) | 10.5 (9-13) | .08 |
| Laboratory values | |||
| Maximum ferritin, μg/L | 20 707 (3903-40 000) | 573 (32-40 000) | <.001 |
| Maximum rate of ferritin rise, μg/L/h | 591 (100-1279) | 7.5 (0.13-1151) | <.001 |
| Maximum triglycerides, mg/dL | 475 (67-1095) | 301 (124-784) | .18 |
| Minimum fibrinogen, mg/dL | 183 (91-426) | 221 (117-426) | <.001 |
| Maximum AST, U/L | 153 (32-1806) | 48 (18-225) | <.001 |
| Maximum ALT, U/L | 76 (29-1076) | 50 (14-341) | .08 |
| Maximum CRP, mg/L | 30 (6.1-143) | 60 (0.8-333) | .03 |
| Maximum D-dimer, ng/mL | 14 000 (4754-14 000) | 3010 (415-14 000) | <.001 |
| Maximum LDH, U/L | 964 (260-2700) | 202 (98-994) | <.001 |
| Clinical course | |||
| Any CRS | 12 (100%) | 36 (84%) | .33 |
| Maximum CRS grade | .99 | ||
| Grade 1 | 6 (50%) | 18 (50%) | |
| Grade 2 | 6 (50%) | 18 (50%) | |
| CRS duration, d | 5 (2-9) | 3 (1-9) | .03 |
| Any neurotoxicity | 5 (42%) | 6 (14%) | .05 |
| Maximum neurotoxicity grade | .74 | ||
| 1 | 2 (40%) | 4 (67%) | |
| 2 | 1 (20%) | 1 (17%) | |
| ≥3 | 2 (40%) | 1 (17%) | |
| Received tocilizumab | 12 (100%) | 30 (70%) | .05 |
| Received systemic steroids | 11 (92%) | 11 (26%) | <.001 |
| Received anakinra | 10 (83%) | 1 (2.3%) | <.001 |
| Hospitalized days following CAR T | 20.5 (14-45) | 19 (13-30) | .009 |
| Required ICU-level care | 3 (25%) | 1 (2.3%) | .03 |
ALT, alanine transaminase; AST, aspartate aminotransferase; BM, bone marrow; FLC, free light chain; Ig, immunoglobulin; LDH, lactate dehydrogenase; WBC, white blood cell.
*
High-risk cytogenetics defined as the presence of del 17p, t(4;14), or t(14,16) on pre-CAR T bone marrow biopsy.
†
Infection defined as: culture positivity, febrile neutropenia, or clinical suspicion such that new antimicrobials were initiated in 30 d before receiving CAR T.