Decreased renal function predicts severe cytokine release syndrome after <scp>CAR</scp> ‐T‐cell therapy for large B‐cell lymphoma
decrease; 95% confidence interval [CI] 1.015-1.209; p = 0.022), higher ferritin (aHR 1.006 per 100 ng/mL; 95% CI 1.001-1.010; p = 0.016), C-reactive protein (CRP) (aHR 1.142 per mg/dL; 95% CI 1.091-1.195; p < 0.001) and lactate dehydrogenase (LDH) (aHR 1.073 per 100 U/L; 95% CI 1.008-1.142; p = 0.028) independently predicted grade ≥ 2 CRS. We then built a four-factor CRS pre-infusion risk evaluation model, cytokine release syndrome-pre-infusion risk evaluation (CRS-PRE), that stratified grade ≥ 2 CRS risk into low, intermediate and high groups with incidences of 2.8%, 26.0% and 50.0% respectively. Decreased eGFR, a surrogate of host renal reserve, with elevated ferritin, CRP and LDH emerged as predictors of high-grade CRS. The CRS-PRE may facilitate risk-adapted monitoring and intervention in clinical practice.
Authors
- Yoshihiro Umezawa (ORCID: https://orcid.org/0000-0003-1027-1552)
- Tatsu Shimoyama
- Tomoyasu Jo (ORCID: https://orcid.org/0000-0001-9381-0421)
- Daisuke Kaji (ORCID: https://orcid.org/0000-0002-9256-609X)
- Motohiro Kato (ORCID: https://orcid.org/0000-0001-5145-1774)
- Yasuyuki Arai (ORCID: https://orcid.org/0000-0002-9662-5093)
- Haryoon Kim
- Shinichi Makita
- Toshio Kitawaki
- Satoshi Yoshihara
- Kazuyuki Shimada
- Takayuki Sato
- Hideki Goto
- Emiko Sakaida
- Go Yamamoto
- Keisuke Kataoka
- Yasuhiro Nakashima
- Akiyo Yoshida
- Koji Kato
- Masatoshi Sakurai
- Nobuharu Fujii
- Yoshiko Atsuta
Institutions
- Aichi Medical University (JP)
- Keio University (JP)
- Kyoto University (JP)
- Tokyo Metropolitan Komagome Hospital (JP)
- Kurashiki Central Hospital (JP)
- Kyushu University Hospital (JP)
- Chiba University Hospital (JP)
- Okayama University Hospital (JP)
- Kanazawa University Hospital (JP)
- University of Tokyo Hospital (JP)
- Hokkaido University Hospital (JP)
- Kyoto University Hospital (JP)
- The Japanese Data Center for Hematopoietic Cell Transplantation (JP)
- Tokyo National Hospital (JP)
- Osaka City University Hospital (JP)
- Toranomon Hospital (JP)
- Osaka Metropolitan University (JP)
- Nagoya University (JP)
- The University of Tokyo (JP)
Publication Details
- Journal
- British Journal of Haematology
- Published
- 2026-04-15
- DOI
- https://doi.org/10.1111/bjh.70488
- Primary Topic
- CAR-T cell therapy research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Ministry of Education, Culture, Sports, Science and Technology
- Japan Society for the Promotion of Science