CAR-T treatment does not increase AKI or death risk in patients with CKD
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Patients with chronic kidney disease are not at an increased risk for AKI or death after chimeric antigen receptor T-cell therapy, according to a speaker at ASN Kidney Week.
“A paucity of data exists of renal outcomes in patients treated with [chimeric antigen receptor T-cell] CAR-T, especially with CKD,” Rehan Ansari, MD, of Case Western Reserve University in Cleveland, and colleagues wrote. “We aim to further elucidate renal outcomes in patients treated with CAR-T at our institution.”
Researchers observed 39 adult participants (mean age, 58.7 years; 24 men; 15 women) who received CAR-T between July 2018 and May 2021, while paying attention to baseline demographics and serum laboratory values. Using Fisher’s exact tests, researchers assessed correlations of univariate risk ratios.
“Our primary outcome was to compare the incidence of AKI death and cytokine release syndrome between patients with and without CKD as defined by [Kidney Disease: Improving Global Outcomes] KDIGO,” Ansari said.
Among the 39 participants, 14 experienced mild CKD (GFR <90 mL/min/1.73 m²), four experienced moderate CKD (GFR <60 mL/min/1.73 m²), 22 experienced cytokine release syndrome and six required ICU care.
Among the nine patients with AKI, five resolved, two progressed and two patients died. In total, 10 patients in the study died after receiving CAR-T.
Results revealed underlying hypertension and AKI was associated with death, and ICU stay correlated with AKI. However, there was no association between CRS and the development of AKI.
“In conclusion, we also found a low incidence of AKI and CAR-T therapy, with no correlation with baseline renal function. CRS did not correlate with AKI. Advanced CKD had strong correlation with age and atrial fibrillation,” Ansari said. “Not surprisingly, higher incidence of AKI was noted in ICU admissions and was an independent risk factor for mortality.”
He noted, “The number of patients receiving CAR-T therapy is likely to increase dramatically in the near future.”
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Ansari R, et al. Paper TH-OR10. Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
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