W119 - Neurofilament Light Chain Levels as a Potential Biomarker of Immune effector Cell-Associated Neurotoxicity Syndrome (ICANS) in Patients Treated with CAR T Cell Therapy

Wednesday, June 22, 2022

6:15 PM – 7:30 PM PT

Presenting Author(s)

IO

Iñaki Ortiz de Landazuri, n/a

Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain

Co-Author(s)

GM

Guillermo Muñoz Sánchez, n/a

Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic of Barcelona, Barcelona, Spain.
Barcelona, Catalonia, Spain
VO

Valentín Ortiz Maldonado, n/a

Hematology Department, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
AO

Aina Oliver-Caldes, n/a

Hematology Department, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
VB

Victor Bolaño, n/a

Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
ME

Marta Español Rego, n/a

Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
LN

Laura Naranjo, n/a

Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
JD

Julio Delgado, n/a

Hematology Department, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
CF

Carlos Fernández de Larrea, n/a

Hematology Department, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
SR

Susana Rives, n/a

Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu Barcelona, Barcelona
Barcelona, Catalonia, Spain
YB

Yolanda Blanco, n/a

Neurology Department, ICN, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
AS

Albert Saiz, n/a

Neurology Department, ICN, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
MP

Mariona Pascal, n/a

Department of Immunology, Centre de Diagnòstic Biomèdic, Hospital Clínic of Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
Manel Juan, n/a

Head of Department
Department of Immunology, Centre de Diagnòstic Biomèdic, Hospital Clínic of Barcelona, Barcelona, Spain.
Barcelona, Catalonia, Spain
RR

Raquel Ruiz-García, n/a

Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain

The Immune effector Cell-Associated Neurotoxicity Syndrome (ICANS) is an adverse event associated to Chimeric Antigen Receptor (CAR) T-cell therapy. Neurofilament light chain (NfL) levels have been proposed as a biomarker of neuroinflammation. We hypothesize that NfL could be employed as a biomarker of ICANS risk and severity in CAR T-cell therapy.

We retrospectively measured serum or plasma NfL levels in a cohort of 29 patients who received CAR T-cells against CD19 (n=24) or BCMA (n=5), and 53 age matched healthy donors (HD). Fifteen patients presented ICANS of any grade. Blood samples were obtained at pre, intra and post ICANS episodes in ICANS study group; and at day 0, +7 and +28 after CAR T-cell infusion in patients without ICANS (NO-ICANS).

Both ICANS and NO-ICANS showed higher levels of NfL in comparison to HD prior to CAR T-cell infusion (median: 36.65pg/mL; 52.84pg/mL; 14.96pg/mL).

Grade 3-4 ICANS and grade 1-2 ICANS had a NfL mean of 57.2pg/mL and 28.5pg/mL during episodes, respectively; while NO-ICANS showed a mean of 43.6pg/mL at day+7. Significant differences comparing grade 3-4, 1-2 grade ICANS and NO-ICANS were not observed.

Differences in NfL levels between ICANS (47pg/mL) and NO-ICANS (53.5pg/mL) were not detected post ICANS resolution and at day+28, respectively.

High baseline NfL levels were present in both ICANS and NO-ICANS groups before CAR-T cell therapy. Differences in NfL levels were not observed in patients with ICANS of any grade compared to NO-ICANS group. NfL levels may not help to assess ICANS risk or severity in our cohort.