The Role of the Modified Endothelial Activation and Stress Index (mEASIX) in Predicting the Efficacy of CAR-T Cell Therapy and Cytokine Release Syndrome (CRS).
10.19746/j.cnki.issn.1009-2137.2025.04.039
- Author:
Jin HU
1
;
Qian-Nan HAN
1
;
Feng-Yi LU
1
;
Xin-Yue ZHOU
1
;
Zhi-Qin YANG
1
;
Kai-Lin XU
1
;
Wei CHEN
1
Author Information
1. Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu Province, China.
- Publication Type:Journal Article
- Keywords:
mEASIX;
CAR-T therapy;
CRS;
B-cell tumors
- MeSH:
Cytokine Release Syndrome/therapy*;
Immunotherapy, Adoptive/methods*;
Humans;
Lymphoma, B-Cell/therapy*;
Retrospective Studies;
Hematology;
China;
Receptors, Chimeric Antigen/blood*;
Predictive Value of Tests
- From:
Journal of Experimental Hematology
2025;33(4):1190-1198
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the predictive role of the modified Endothelial Activation and Stress Index (mEASIX) in the efficacy of chimeric antigen receptor T-cell (CAR-T) therapy and cytokine release syndrome (CRS).
METHODS:The clinical data of 70 relapsed and refractory (R/R) B-cell tumor patients who were treated with CAR-T therapy from September 1, 2018 to February 28, 2023 in the Department of Hematology, Affiliated Hospital of Xuzhou Medical University, were retrospectively analyzed. The value of log-2 mEASIX before conditioning (-7 d) was calculated, and the patients were divided into a low-mEASIX group (42 patients) and a high-mEASIX group (28 patients) based on the cut-off value of 5.443 determined by the receiver operating characteristic (ROC) curve. Eventually, the predictive role of mEASIX before conditioning on the efficacy of CAR-T cell therapy and CRS was analyzed.
RESULTS:The high-mEASIX group exhibited significantly worse median overall survival (OS) and median progression-free survival (PFS) in comparison to the low mEASIX group (OS: 3.2 months vs not reached, P < 0.01; PFS: 1.3 months vs 6.0 months, P =0.009). The incidence of grade ≥2 CRS in the high-mEASIX group was substantially higher than that in the low-mEASIX group (57.1% vs 19.0%, P =0.007). The degree of remission after CAR-T therapy (P =0.001), whether CRS occurs or not (P =0.041), the lactate dehydrogenase (LDH) level before conditioning (P =0.046), and the mEASIX score before conditioning (P =0.047) were independent influencing factors for the OS of patients receiving CAR-T cell therapy.
CONCLUSION:The mEASIX score before conditioning can predict OS and the incidence of grade ≥2 CRS in patients with relapsed and refractory B-cell tumors who receive CAR-T cell therapy.
