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Nutritional status alterations after chimeric antigen receptor T cell therapy in patients with hematological malignancies: a retrospective study

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Abstract

Purpose

The influence of innovative chimeric antigen receptor T cell (CAR-T) therapy for hematological malignancies on nutritional status remains unknown. Therefore, we aim to explore the alterations of nutritional status after CAR-T cell therapy in patients with hematological malignancies.

Methods

We retrospectively collected the data of patients with acute leukemia (AL), lymphoma, and multiple myeloma (MM), who underwent CAR-T therapy at our hospital from 2018 to 2020. The serum albumin, triglyceride, and cholesterol before and 7, 14, and 21 days after CAR-T cell infusion were compared and analyzed.

Result

A total of 117 patients were enrolled, consisting of 39 AL, 23 lymphoma, and 55 MM patients. The baseline albumin, triglyceride, and cholesterol were 37.43 ± 5.08 mg/L, 1.63 ± 0.74 mmol/L, and 3.62 ± 1.03 mmol/L, respectively. The lowest albumin level was found at 7 days after CAR-T cell infusion compared with baseline (P < 0.001), while the levels of triglyceride increased at 14 and 21 days (P < 0.001, P = 0.036). The levels of cholesterol at 7, 14, and 21 days after CAR-T cell infusion were lower than baseline (all P < 0.05). Spearman’s correlation coefficient showed cytokine release syndrome grade was negatively correlated with the levels of albumin at 7 days and cholesterol at 21 days after CAR-T cell infusion (r =  − 0.353, P < 0.001; r =  − 0.395, P = 0.002).

Conclusion

The alterations of different nutrition-related biochemical parameters varied after CAR-T cell therapy. The levels of albumin and total cholesterol after CAR-T cell infusion were negatively correlated with the grade of cytokine release syndrome. Specific screening and intervention for malnutrition in patients receiving CAR-T cell therapy need to be explored in further studies.

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Availability of data and material

Data is available on request.

Code availability

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Funding

This work was supported by the Medical Science and Technology Project of Zhejiang Provincial Health Commission (grant no. 2021432523) and Department of Education of Zhejiang Province (grant no. Y202043556).

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Authors and Affiliations

  1. Nursing Department, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

    Shuyi Ding, Lingxia Cai, Aiyun Jin, Xiaoyu Zhou & Jiali Yan

  2. Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, No.79 Qingchun Road, Hangzhou, China

    Shuyi Ding, Lingxia Cai, Aiyun Jin, Xiaoyu Zhou, Jiali Yan, Linqin Wang, Houli Zhao & Yongxian Hu

  3. Institute of Hematology, Zhejiang University, Hangzhou, China

    Linqin Wang, Houli Zhao & Yongxian Hu

  4. Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China

    Linqin Wang, Houli Zhao & Yongxian Hu

  5. Liangzhu Laboratory, Zhejiang University Medical Center, 1369 West Wenyi Road, Hangzhou, 311121, China

    Linqin Wang, Houli Zhao & Yongxian Hu

  6. Department of Nutrition, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

    Tingting Wang

Authors
  1. Shuyi Ding
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  2. Lingxia Cai
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  3. Aiyun Jin
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  4. Xiaoyu Zhou
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  8. Tingting Wang
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Contributions

Shuyi Ding, Lingxia Cai, Aiyun Jin, Xiaoyu Zhou, Jiali Yan, and Tingting Wang designed the study and collected the data. Linqin Wang and Houli Zhao analyzed the data and wrote the manuscript. Yongxian Hu proofread the manuscript.

Corresponding author

Correspondence to Yongxian Hu.

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Ethics approval

These clinical trials were performed according to the ethical principles of the Declaration of Helsinki. Approval was granted by the Medical Ethics Committee of the First Affiliated Hospital of Medical College, Zhejiang University (ChiCTR-ORN-16008948, ChiCTR1800015575, ChiCTR-OIC-17011310, ChiCTR1800017404).

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The authors declare no competing interests.

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Ding, S., Cai, L., Jin, A. et al. Nutritional status alterations after chimeric antigen receptor T cell therapy in patients with hematological malignancies: a retrospective study. Support Care Cancer 30, 3321–3327 (2022). https://doi.org/10.1007/s00520-021-06639-2

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  • DOI: https://doi.org/10.1007/s00520-021-06639-2

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