Study participants were in critical condition and had received CAR-T (chimeric antigen receptor T) cells. Investigating the entire medical center’s past. All patients who received a CAR-T cell and subsequently needed intensive care unit admission between July 2017 and December 2020 were considered. For a period of 4-7 days following CAR-T cell infusion, 71 patients, with a median age of 60 [37-68] years old, were admitted to the intensive care unit. The most prevalent forms of cancer were multiple myeloma (1 case, 1.4%), diffuse large B cell lymphoma (53 cases, 75%), and acute lymphoblastic leukaemia (17 cases, 24%). Performance Status was 1 (between 1-2). Shock was the leading cause of intensive care unit admissions (n=40, 48%). The most common complication was isolated cytokine release syndrome (n=33, 46%), and the bacterial infection was confirmed microbiologically in 21 patients (30%). (most often due to catheter-related infections). Immune effector cell-related neurotoxicity syndrome was diagnosed in 26 patients (37%). Of the total number of patients admitted to the intensive care unit, 18 (25%) required vasopressors and 2 (0.5%) required invasive mechanical ventilation. In total, 49 people were treated with tocilizumab (69%) and steroids (56%). Mortality was associated with the underlying conditions that necessitated ICU admission (disease progression vs. sepsis or CRS; HR 4.02; 95% CI 1.10-14.65), with the patient’s Performance Status (HR 1.97/point; 95% CI 1.14-3.41), and with the patient’s Sequential Organ Failure Assessment (SOFA) score (HR 1.16/point; 95% CI 1.01-1.33). CAR-T cell recipients may experience a meaningful survival rate of 50% or higher. Death was often predicted by the severity of organ failure, especially in patients whose health was deteriorating or whose performance status was changing.
Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-022-01036-2
