Real-world assessment of prophylactic anakinra on neurotoxicity and cytokine release syndrome after CD19 CAR T-cell therapy in R/R B-cell lymphoma: An inverse probability of treatment weighting analysis.
Routine preventive anakinra didn't help CAR-T lymphoma patients and linked to more infections, guiding smarter treatment selection.
In 176 high-risk lymphoma patients receiving CD19 CAR-T therapy at a single center with IPTW analysis, prophylactic anakinra failed to reduce severe ICANS and was associated with a 7-fold higher odds of grade ≥3 infections by day 30 versus controls. This important negative real-world finding challenges the rationale for routine prophylactic anakinra outside clinical trials.
What the study was
- Study design
- Retrospective cohort, IPTW analysis
- Population
- High-risk adults with R/R B-cell NHL receiving CD19 CAR T-cell therapy, age ≥65 or CD28 co-stimulatory domain product, n=176
- Sample size
- 176
- Category
- Treatment Innovation
- Maturity
- Exploratory
- Journal
- Transplant Cell Ther
Why it surfaced
Clinically impactful negative finding: prophylactic anakinra for CAR-T toxicity prevention not supported in this real-world IPTW analysis (n=176). Challenges off-label practice. Single-center and retrospective limitations acknowledged.
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