Authors
Eugenio Galli, Daniele Mannina, Alessandro Corrente, Chiara De Philippis, Ilaria Pansini, Marcello Viscovo, Stefan Hohaus, Patrizia Chiusolo, Federica Sorà, Stefania Bramanti, Simona Sica
Published in
European journal of haematology. Aug 28, 2026. Epub Aug 28, 2026.
Abstract
Baseline systemic inflammation has emerged as a determinant of outcome after CD19-directed CAR-T therapy. We evaluated the prognostic performance of the recently developed INFLAmmation MIXture Model (InflaMix) in an independent bicentric cohort of patients with large B-cell lymphoma (LBCL) receiving commercial CAR-T cells, focusing on treatment-related toxicities.
We retrospectively analyzed 212 consecutive patients with relapsed/refractory LBCL treated with axi-cel, tisa-cel, or liso-cel between 2020 and 2026. Patients were classified according to the InflaMix inflammatory phenotype. Progression-free survival (PFS), CAR-T-related toxicities, ICU admission, and concordance with CAR-HEMATOTOX and mEASIX were assessed.
An inflammatory InflaMix phenotype was identified in 21% of patients and was associated with inferior PFS (12-month PFS: 30% vs. 56%; p < 0.001). While overall grade 2-4 CRS and ICANS rates were comparable, inflammatory patients showed higher rates of grade 3-4 CRS (11.1% vs. 1.8%; OR 3.18) and ICU admission (24.4% vs. 5.6%; OR 3.00). No association with ICAHT was observed. Concordance was poor with CAR-HEMATOTOX and moderate with mEASIX.
InflaMix was externally validated as a predictor of inferior PFS, severe CRS, and ICU admission after CAR-T therapy, and candidates as a practical tool for pre-infusion risk stratification and as a complement to existing scores.
PMID:
42663433
Bibliographic data and abstract were imported from PubMed on 28 Aug 2026.
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