Abstract 12429: Grade Of CRS is Associated With Cardiac Dysfunction in the Acute Phase, but Do Not Predict the Prognosis of Diffuse Large B Cell Lymphoma Patients Who Underwent CAR-T Therapy

Introduction: As Chimeric Antigen Receptor T cell (CAR-T) therapy gains advantage in the management of diffuse large B cell lymphoma (DLBCL), accumulating evidence shows that it frequently accompanies cardiac dysfunction. Previous retrospective studies indicated the potential involvement of cytokine release syndrome (CRS) in cardiac dysfunction after CAR-T therapy, but no prospective study has reported the time course of cardiac dysfunction and its association with prognosis. Purpose: To prospectively examine the sequential changes in cardiac markers over time after CAR-T therapy and to clarify their association between the grade of CRS, cardiac markers, and prognosis. Methods: In this prospective study, 30 DLBCL patients who underwent CAR-T therapy were enrolled. Before and after the treatment, the level of cardiac biomarkers and echocardiographic index were sequentially collected. We classified all patients into two groups according to the severity of CRS after CAR-T therapy, namely Low-CRS group (CRS<2) and High-CRS group (CRS≧2). Cardiac biomarkers, echocardiographic index, and long-term survival prognosis were further analyzed in both groups. Results: The average age of participants was 59.6 years, and 9 (30%) were female. The number of patients in Low- and High-CRS group was 13 and 17, respectively. At the baseline before CAR-T therapy, there were no significant differences in cardiac parameters between two groups. In High-CRS group, NT-proBNP levels were significantly increased on day 3 and 7 compared to the baseline and were significantly higher than Low-CRS group at both timepoints, whereas troponin T level did not show any differences. Likewise, in High-CRS group, GLS was significantly decreased on day 7 and 14 compared to the baseline and recovered toward baseline on day 28. GLS and EF did not show significant differences between Low- and High-CRS groups throughout the follow-up. The Kaplan-Meier analysis demonstrated that there was no significant difference in long-term survival prognosis according to the severity of CRS. Conclusion: This study revealed that CAR-T therapy induced transient changes in NT-proBNP level and GLS especially in High-CRS group in the first 2 weeks, but they did not predict the long-term prognosis.