PP438 - SIGNIFICANT WEIGHT LOSS IN A CAR T-CELL: SIZE DOES SEEM TO MATTER!
PP438
SIGNIFICANT WEIGHT LOSS IN A CAR T-CELL: SIZE DOES SEEM TO MATTER!
L. Maia Moço1,*, A. Fontoura Alves1, A. Amarante1, A. M. Hortas2, I. Clara1, G. de Câmara Negalha1, P. Alves3, A. Espírito Santo1, D. Duarte1, S. Couto Irving3, M. Mariz1
1Department of Hematology and Bone Marrow Transplantation, Instituto Portugues de Oncologia do Porto Francisco Gentil, Porto , 2Department of Clinical Hematology, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, Vila Real, 3Department of Nutrition, Instituto Portugues de Oncologia do Porto Francisco Gentil, Porto , Portugal
Rationale: Nutritional status seems to influence outcomes in T cell-based immunotherapies. However, in chimeric antigen receptor (CAR) T-cell therapy, its clinical significance remains unclear. Significant weight loss (SWL) is associated with adverse haematological parameters and may be a putative prognostic marker.
Methods: Single-centre retrospective cohort included adults treated with CAR T (2019-2025). SWL was defined as >5% weight loss, assessed between referral (C) – pre-lymphodepletion (L) (ΔC–L), and apheresis (A) – L (ΔA–L). Endpoints included overall survival (OS), progression-free survival (PFS) and duration of response (DoR). Associations were tested using chi-square/Fisher, Mann–Whitney/Student’s t-test, Cox proportional hazards and logistic regression models.
Results: From 98 patients (median age 57; male:female 1.4:1, mostly DLBCL), SWL was identified in 16% (ΔC–L) and 14% (ΔA–L). No statistically significant differences were observed in OS, PFS, or DoR between SWL and no-SWL groups. SWL in ΔC–L correlated with lower hemoglobin (Hb), absolute lymphocyte count (ALC), and prognostic nutritional index (PNI) at L (p<0.001, 0.017, 0.049) and with lower Hb at infusion (t0) (p=0.042). In ΔA–L, only ALC at t0 was reduced in the SWL group (p=0.019). Several markers of malnutrition were associated with OS/PFS/DoR in univariate analysis. In multivariate models, only ALC at t0 and C-reactive protein at L remained independent predictors of PFS (p=0.032; HR1.01, 95%CI 1.001-1.020) and DoR (p=0.015; HR1.005, 95%CI 1.001-1.010).
Conclusion: After an initial detrimental signal in the SWL group, the KM curves cross, which could be consistent with attenuation due to a systematic nutrition care process (selection effect/confounding by indication). Despite limitations (retrospective/sample size), findings highlight the importance of SWL awareness, the need to document nutritional status/intervention and future prospective trials.
Disclosure of Interest: None declared