Applying the EHA/EBMT Grading System for Icaht Following CAR-T Therapy | Kai Rejeski, MD | ASH 2023

My name is Kai Rogieski from the Almew University Hospital in Munich and I had the pleasure on speaking about immune effector cell associated hematoxyste or ICAT after car T cell therapy. And so we did a multi-center retrospective analysis of about 550 patients across three retrospective courts spanning five car products and we studied the incidence rates and the severity of prolonged cytopenias, meaning low blood counts after car T cell therapy. And so in this study we were able to show that the distribution of severity grades using this new grading system differs between disease entities and according to the car product. So we saw that there's a little bit more prolonged cytopenias with the patients receiving brexitcaptogen autosul for relapsed refractory mantle cell lymphoma compared to both LBCL but also multiple myeloma. And we performed specific analyses to try to understand so the risk factors better. We found that patients that had a lot of inflammation prior to therapy they were at risk patients that had low blood counts already prior to therapy were at a higher risk and this is something I think that's a really relevant side effect of car T cell therapy because we observed that the patients that have these cytopenias these low blood counts they also have a higher incidence rate of infections and deaths related to non-progression related events which we call non-relapse mortality. And so finally we showed that this grading system that was developed together with the European Hematology Association or EHA and the European Bone Marrow Transplantation Society or EBMT this grading system that we developed it's really clinically relevant in terms of identifying patients that are at really high risk for the consequences of very severe hemotoxicity after car T cell therapy. And so I think what this is giving us is giving us sort of an expected framework as to how often we observe the side effects across different car products across different disease entities that's the one and I think this is really the basis to now compare this toxicity hemotoxicity in a really standardized and harmonized manner and hopefully we can now develop the same type of sort of severity based recommendations for this toxicity as what we currently have for CRS and ICANTS.