InflaMix Predicts Severe CRS, ICU Admission, and Progression‐Free Survival After CAR‐T Therapy in LBCL
- 1Department of Laboratory and Hematological Sciences Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
- 2Department of Hematology IRCCS Humanitas Research Hospital Rozzano Italy
- 3Hematology Section, Department of Radiologic and Hematologic Sciences Università Cattolica del Sacro Cuore Italy
Abstract
Objectives: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
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BibTeX
@article{galli2026inflamix,
title = {{InflaMix Predicts Severe CRS, ICU Admission, and Progression‐Free Survival After CAR‐T Therapy in LBCL}},
author = {Eugenio Galli and Daniele Mannina and Alessandro Corrente and Chiara De Philippis and Ilaria Pansini and Marcello Viscovo and Stefan Hohaus and Patrizia Chiusolo and Federica Sorà and Stefania Bramanti and Simona Sica},
journal = {European Journal of Haematology},
year = {2026},
month = aug,
doi = {10.1111/ejh.70307},
url = {https://doi.org/10.1111/ejh.70307},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - InflaMix Predicts Severe CRS, ICU Admission, and Progression‐Free Survival After CAR‐T Therapy in LBCL
AU - Eugenio Galli
AU - Daniele Mannina
AU - Alessandro Corrente
AU - Chiara De Philippis
AU - Ilaria Pansini
AU - Marcello Viscovo
AU - Stefan Hohaus
AU - Patrizia Chiusolo
AU - Federica Sorà
AU - Stefania Bramanti
AU - Simona Sica
PY - 2026
DA - 2026/08/28
JO - European Journal of Haematology
DO - 10.1111/ejh.70307
UR - https://doi.org/10.1111/ejh.70307
AB - Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
SN - 0902-4441
SN - 1600-0609
ER -