{"doi":"10.6004/jnccn.2022.7100","title":"Association Between Pretreatment Skeletal Muscle and Outcomes After CAR T-Cell Therapy","abstract":"BACKGROUND: The purpose of this study was to examine the association between baseline skeletal muscle measurements, acute toxicity (immune effector cell-associated neurotoxicity syndrome [ICANS], cytokine release syndrome), and treatment efficacy in patients undergoing CAR T-cell therapy for B-lineage lymphoma. PATIENTS AND METHODS: Skeletal muscle measurements were obtained from automated CT measurements in 226 consecutive patients who received CAR T-cell therapy between 2015 and 2021. The Kaplan-Meier method was used to examine progression-free survival (PFS) and overall survival (OS) at 1-year. Multivariable regression was used to calculate the hazard ratio (HR) with 95% confidence intervals, adjusted for covariates. RESULTS: The median age of the cohort was 63.1 years (range, 18.5-82.4 years), and most patients were male (66%) and had primary refractory disease (58%). Patients with abnormally low skeletal muscle at baseline were at greater risk of ICANS (HR, 1.74; 95% CI, 1.05-2.87) and had longer length of hospitalization (mean 27.7 vs 22.9 days; P<.05) compared with those with normal muscle mass. Abnormal skeletal muscle was independently associated with risk of disease progression (HR, 1.70; 95% CI, 1.11-2.57) and worse survival (HR, 2.44; 95% CI, 1.49-4.00) at 1 year compared with normal skeletal muscle. Individuals who had abnormal skeletal muscle and high lactate dehydrogenase (LDH) levels at baseline had poor 1-year PFS (17%) and OS (12%) compared with those with normal skeletal muscle and LDH levels (72% and 82%, respectively; P<.001). Patients who had abnormal skeletal muscle and LDH levels had a 5-fold risk (HR, 5.34; 95% CI, 2.97-9.62) of disease progression and a 10-fold risk (HR, 9.73; 95% CI, 4.81-19.70) of death (reference: normal skeletal muscle, normal LDH), independent of prior lines of therapy, extent of residual disease at time of CAR T-cell therapy, functional status, or product. CONCLUSIONS: This information can be used for risk stratification prior to CAR T-cell therapy or to implement prehabilitation and nutritional optimization before lymphodepletion as well as thereafter. These efforts will be complementary to ongoing efforts toward sustained efficacy after CAR T-cell therapy.","journal":"Journal of the National Comprehensive Cancer Network","year":2023,"id":345878,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.66,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":535120,"name":"Aleksi Iukuridze","orcid":"0000-0001-9444-1939","position":1,"is_corresponding":false},{"id":940455,"name":"Tianhui He","orcid":null,"position":2,"is_corresponding":false},{"id":820665,"name":"Alysia Bosworth","orcid":"0000-0002-0662-5699","position":3,"is_corresponding":false},{"id":535833,"name":"Lanie Lindenfeld","orcid":null,"position":4,"is_corresponding":false},{"id":799832,"name":"Jennifer Berano Teh","orcid":"0000-0003-0964-3128","position":5,"is_corresponding":false},{"id":535121,"name":"Meagan Echevarria","orcid":"0000-0001-8181-410X","position":6,"is_corresponding":false},{"id":1085868,"name":"Sophia Albanese","orcid":"0009-0004-0471-5668","position":7,"is_corresponding":false},{"id":799834,"name":"Liezl Atencio","orcid":"0000-0001-6590-210X","position":8,"is_corresponding":false},{"id":939852,"name":"Rusha Bhandari","orcid":"0000-0003-2069-1518","position":9,"is_corresponding":false},{"id":341507,"name":"F. Lennie Wong","orcid":"0000-0002-4333-5017","position":10,"is_corresponding":false},{"id":316813,"name":"Andrew Artz","orcid":"0000-0003-0803-9607","position":11,"is_corresponding":false},{"id":11104,"name":"Tanya Siddiqi","orcid":"0000-0001-5292-8298","position":12,"is_corresponding":false},{"id":415400,"name":"Liana Nikolaenko","orcid":"0000-0003-0542-1712","position":13,"is_corresponding":false},{"id":286216,"name":"Jasmine Zain","orcid":"0009-0009-0753-1019","position":14,"is_corresponding":false},{"id":387636,"name":"Matthew Mei","orcid":"0000-0002-1109-6955","position":15,"is_corresponding":false},{"id":643201,"name":"Geoffrey Shouse","orcid":"0000-0002-7917-5713","position":16,"is_corresponding":false},{"id":457037,"name":"Leslie Popplewell","orcid":"0000-0002-8418-2811","position":17,"is_corresponding":false},{"id":282395,"name":"Alex F. Herrera","orcid":"0000-0002-9665-7415","position":18,"is_corresponding":false},{"id":457034,"name":"Lihua E. Budde","orcid":"0000-0003-1464-5494","position":19,"is_corresponding":false},{"id":249979,"name":"Stephen J. Forman","orcid":"0000-0002-2803-4152","position":20,"is_corresponding":false},{"id":401865,"name":"Saro H. Armenian","orcid":"0000-0003-2604-8603","position":21,"is_corresponding":false},{"id":383612,"name":"Kyuwan Lee","orcid":"0000-0002-2015-4109","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T01:11:44.152490Z","pmid":"37015335","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}