CAR T therapy in adult DLBCL patients in Slovenia: Evaluation of predictive scores for outcomes and adverse events

CAR T cell therapy is a promising immunotherapy for hematologic malignancies, yet early prediction of outcomes and adverse events remains difficult, especially in small real-world cohorts. We retrospectively analyzed 14 adult patients with diffuse large B-cell lymphoma (DLBCL) treated with CAR T cells in Slovenia, assessing IL-6 increase rates and established predictive metrics including EASIX-C, CAR-HEMATOTOX, and IBPS on Day −5 (pre-lymphodepletion) and Day 0 (infusion). Contrary to our expectation, an inverse correlation was observed between the increase rate of IL-6 and the occurrence of severe cytopenias, indicating higher IL-6 increase rate leads to less severe cytopenias. The EASIX-C score showed higher predictive values when calculated on Day 0, contrary to the CAR-HEMATOTOX score, whose higher predictive values were observed on Day −5. The IBPS predictive values showed mixed results when comparing Day −5 to Day 0. We observed 50% response rate and 29% remission rate. The results highlight the utility of predictive scores, with unexpected findings on IL-6 suggesting further study is necessary. CAR T cell therapy is an innovative treatment that uses a patient’s own immune cells to fight blood cancer. This study looked at adult patients in Slovenia who received this therapy and evaluated whether certain early warning scores could predict serious side effects and treatment outcomes. Interestingly, we found that faster increases in a protein called IL-6 were linked to fewer issues with low blood counts, which was unexpected. Two scores – EASIX-C and CAR-HEMATOTOX – were found to be helpful in predicting a brain-related side effect called ICANS. Overall, about half of the patients showed improvement, and nearly one-third went into remission. These findings suggest that using these scores before and during treatment could help doctors better manage risks and improve patient care.