Table 1.

Patient, laboratory, and clinical characteristics for patients who developed MAS-L vs patients who did not

N or median (% or range)
MAS-L (n = 12)No MAS-L (n = 43)P
Patient characteristics 
Median age, y 64.1 (43.3-74.2) 62.4 (33.7-77.3) .87 
Female 3 (25%) 25 (58.1%) .06 
Type of MM    
 IgA-K 2 (16.7%) 8 (18.6%) .94 
 IgA-L 0 (0%) 2 (4.7%)  
 IgD-K 0 (0%) 1 (2.3%)  
 IgG-K 6 (66.7%) 21 (48.9%)  
 IgG-L 1 (8.3%) 7 (16.3%)  
 LC-K 1 (8.3%) 4 (9.3%)  
High-risk cytogenetics* 8 (66.7%) 30 (69.8%) 1.0 
Baseline % BM plasma cells 40 (0- 95) 25 (0-100) .62 
Baseline FLC, K/L ratio 176 (1.5-1311) 203.2 (2.2-11 054) .62 
Baseline M-protein, g/dL 2.6 (0-4.8) 1.4 (0-6.2) .22 
Median prior lines of treatment 6 (4-13) 5 (1-12) .09 
Use of bridging chemotherapy 8 (66.7%) 27 (62.8%) 1.0 
Median infused CART dose (×106 cells) 300 (47.3-600) 300 (41.8-600) .05 
Infection before CART therapy 9 (75%) 4 (9.3%) <.001 
Time from infection to CART, d 18 (8-29) 10.5 (9-13) .08 
Laboratory values 
Maximum ferritin, μg/L 20 707 (3903-40 000) 573 (32-40 000) <.001 
Maximum rate of ferritin rise, μg/L/h 591 (100-1279) 7.5 (0.13-1151) <.001 
Maximum triglycerides, mg/dL 475 (67-1095) 301 (124-784) .18 
Minimum fibrinogen, mg/dL 183 (91-426) 221 (117-426) <.001 
Maximum AST, U/L 153 (32-1806) 48 (18-225) <.001 
Maximum ALT, U/L 76 (29-1076) 50 (14-341) .08 
Maximum CRP, mg/L 30 (6.1-143) 60 (0.8-333) .03 
Maximum D-dimer, ng/mL 14 000 (4754-14 000) 3010 (415-14 000) <.001 
Maximum LDH, U/L 964 (260-2700) 202 (98-994) <.001 
Clinical course 
Any CRS 12 (100%) 36 (84%) .33 
Maximum CRS grade   .99 
 Grade 1 6 (50%) 18 (50%)  
 Grade 2 6 (50%) 18 (50%)  
 CRS duration, d 5 (2-9) 3 (1-9) .03 
Any neurotoxicity 5 (42%) 6 (14%) .05 
Maximum neurotoxicity grade   .74 
 1 2 (40%) 4 (67%)  
 2 1 (20%) 1 (17%)  
 ≥3 2 (40%) 1 (17%)  
Received tocilizumab 12 (100%) 30 (70%) .05 
Received systemic steroids 11 (92%) 11 (26%) <.001 
Received anakinra 10 (83%) 1 (2.3%) <.001 
Hospitalized days following CAR T 20.5 (14-45) 19 (13-30) .009 
Required ICU-level care 3 (25%) 1 (2.3%) .03 
N or median (% or range)
MAS-L (n = 12)No MAS-L (n = 43)P
Patient characteristics 
Median age, y 64.1 (43.3-74.2) 62.4 (33.7-77.3) .87 
Female 3 (25%) 25 (58.1%) .06 
Type of MM    
 IgA-K 2 (16.7%) 8 (18.6%) .94 
 IgA-L 0 (0%) 2 (4.7%)  
 IgD-K 0 (0%) 1 (2.3%)  
 IgG-K 6 (66.7%) 21 (48.9%)  
 IgG-L 1 (8.3%) 7 (16.3%)  
 LC-K 1 (8.3%) 4 (9.3%)  
High-risk cytogenetics* 8 (66.7%) 30 (69.8%) 1.0 
Baseline % BM plasma cells 40 (0- 95) 25 (0-100) .62 
Baseline FLC, K/L ratio 176 (1.5-1311) 203.2 (2.2-11 054) .62 
Baseline M-protein, g/dL 2.6 (0-4.8) 1.4 (0-6.2) .22 
Median prior lines of treatment 6 (4-13) 5 (1-12) .09 
Use of bridging chemotherapy 8 (66.7%) 27 (62.8%) 1.0 
Median infused CART dose (×106 cells) 300 (47.3-600) 300 (41.8-600) .05 
Infection before CART therapy 9 (75%) 4 (9.3%) <.001 
Time from infection to CART, d 18 (8-29) 10.5 (9-13) .08 
Laboratory values 
Maximum ferritin, μg/L 20 707 (3903-40 000) 573 (32-40 000) <.001 
Maximum rate of ferritin rise, μg/L/h 591 (100-1279) 7.5 (0.13-1151) <.001 
Maximum triglycerides, mg/dL 475 (67-1095) 301 (124-784) .18 
Minimum fibrinogen, mg/dL 183 (91-426) 221 (117-426) <.001 
Maximum AST, U/L 153 (32-1806) 48 (18-225) <.001 
Maximum ALT, U/L 76 (29-1076) 50 (14-341) .08 
Maximum CRP, mg/L 30 (6.1-143) 60 (0.8-333) .03 
Maximum D-dimer, ng/mL 14 000 (4754-14 000) 3010 (415-14 000) <.001 
Maximum LDH, U/L 964 (260-2700) 202 (98-994) <.001 
Clinical course 
Any CRS 12 (100%) 36 (84%) .33 
Maximum CRS grade   .99 
 Grade 1 6 (50%) 18 (50%)  
 Grade 2 6 (50%) 18 (50%)  
 CRS duration, d 5 (2-9) 3 (1-9) .03 
Any neurotoxicity 5 (42%) 6 (14%) .05 
Maximum neurotoxicity grade   .74 
 1 2 (40%) 4 (67%)  
 2 1 (20%) 1 (17%)  
 ≥3 2 (40%) 1 (17%)  
Received tocilizumab 12 (100%) 30 (70%) .05 
Received systemic steroids 11 (92%) 11 (26%) <.001 
Received anakinra 10 (83%) 1 (2.3%) <.001 
Hospitalized days following CAR T 20.5 (14-45) 19 (13-30) .009 
Required ICU-level care 3 (25%) 1 (2.3%) .03 

ALT, alanine transaminase; AST, aspartate aminotransferase; BM, bone marrow; FLC, free light chain; Ig, immunoglobulin; LDH, lactate dehydrogenase; WBC, white blood cell.

*

High-risk cytogenetics defined as the presence of del 17p, t(4;14), or t(14,16) on pre-CAR T bone marrow biopsy.

Infection defined as: culture positivity, febrile neutropenia, or clinical suspicion such that new antimicrobials were initiated in 30 d before receiving CAR T.

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