Construction of a predictive model for lower respiratory tract infection in children with leukemia after chimeric antigen receptor T cell therapy.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
BACKGROUND: Chimeric antigen receptor T (CAR-T) cells have achieved breakthrough results in the treatment of refractory/relapsed leukemia in children. With the continuous development of research and increasing clinical application, infection events after CAR-T cell therapy have gradually attracted the attention of researchers. Lower respiratory tract infection (LRTI) events accounted for 19.2% of the total number of infection events and resulted in patient death. This study aims to investigate the risk factors of LRTI in children with leukemia who received CAR-T cell therapy and construct a risk predictive model. METHODS: The clinical data of children with leukemia receiving CAR-T cell therapy in a tertiary A children's hospital in Shanghai from November 2023 to December 2024 were retrospectively collected, and the independent risk factors for LRTI were analyzed, and a risk predictive model was constructed. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve were used to evaluate the fitting degree and discrimination of the predictive model, and a nomogram was constructed to visualize the model. RESULTS: A total of 265 cases were included in this study, and the incidence of LRTI within 0-30 days after CAR-T cell therapy was 14.7%. The risk factors for developing LRTI were platelet count (PLT) <50×109/L (X1), minimal residual disease (MRD) >20% (X2), dosage of dexamethasone greater than 10 mg (X3), and allogeneic CAR-T (X4), and the regression equation was: occurrence y (incidence of LRTI) = 1.027 × X1 + 1.079 × X2 + 1.187 × X3 + 1.096 × X4. Hosmer-Lemeshow test showed that χ2 was 2.674 (P=0.95). The area under the ROC curve was 0.781 (P<0.001), the maximum Youden index was 0.468, the cut-off value was 0.139, the sensitivity was 76.9%, and the specificity was 69.9%. CONCLUSIONS: In this study, a risk predictive model for LRTI in children with leukemia within 0-30 days after CAR-T cell therapy was constructed. The predictive factors were PLT <50×109/L, MRD >20%, dexamethasone use greater than 10 mg, and allogeneic CAR-T.