Baseline characteristics at day −5 before initiation of conditioning
| . | Patient 1 . | Patient 2 . | Patient 3 . | Patient 4 . | Patient 5 . | Patient 6 . | Patient 7 . | Patient 8 . |
|---|---|---|---|---|---|---|---|---|
| Age, y | 46 | 72 | 60 | 83 | 59 | 76 | 24 | 38 |
| Sex | Female | Male | Male | Male | Male | Female | Male | Female |
| ECOG PS | 1 | 2 | 0 | 2 | 0 | 1 | 1 | 3 |
| Histology | DLBCL | DLBCL | tFL | DLBCL | DLBCL | tFL | DLBCL | DLBCL |
| Ann Arbor stage | IV | III | IV | IV | IV | III | IV | IV |
| IPI score | 3 | 4 | 3 | 4 | 3 | 3 | 3 | 4 |
| Prior CNS lymphoma | No | No | No | Yes | No | No | No | No |
| Previous treatment | ||||||||
| Previous therapies, n | 2 | 2 | 6 | 3 | 3 | 3 | 3 | 4 |
| Refractory disease | No | No | Yes | Yes | No | Yes | Yes | Yes |
| Previous ASCT | Yes | Yes | Yes | No | Yes | No | No | No |
| Inflammatory and disease burden markers | ||||||||
| CRP, mg/L | 2 | 13 | 51 | 4 | 232 | 35 | 191 | 214 |
| Ferritin, mg/L | 1554 | 1135 | 3332 | 628 | 14 240 | 190 | 8718 | 6183 |
| LDH > ULN | No | No | No | No | Yes | No | Yes | Yes |
| Toxicity management | ||||||||
| Treated toxicity | ICANS G4 | ICANS G3 | ICANS G4 | ICANS G4 | ICANS G4 | ICANS G4 | HLH | HLH |
| Tocilizumab start | Day 4 | Day 5 | — | Day 4 | Day 4 | — | Day 3 | Day 11 |
| Tocilizumab dose | 8 mg/kg IV ×2 | 8 mg/kg IV ×2 | 0 | 8 mg/kg IV ×2 | 8 mg/kg IV ×2 | 0 | 8 mg/kg IV ×1 | 8 mg/kg IV ×2 |
| Corticosteroid start | Day 4 | Day 5 | Day 34 | Day 5 | Day 6 | Day 7 | Day 3 | Day 7 |
| Dexamethasone dose | 8-186 mg ×24 d | 1-186 mg ×57 d | 10 mg ×1 d | 40-186 mg ×13 d | 40-80 mg ×19 d | 4-186 mg ×35 d | 12-186 mg ×14 d | 40-80 mg ×9 d |
| Anakinra start | Day 6 | Day 41 | Day 31 | Day 7 | Day 10 | Day 31 | Day 7 | Day 14 |
| Anakinra dose | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 100 mg SC every other day ×5 | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 200 mg SC daily ×1 |
| Response to anakinra | ||||||||
| Toxicity response | Yes (G0) | Yes (G1) | Yes (G0) | Yes (G2) | No | No | No | No |
| Toxicity recurrence | No | No | No | Yes | Yes | Yes | Yes | Yes |
| Day of death (cause) | — | Day 80 (pneumonia) | Day 71 (HLH) | Day 18 (PD) | Day 31 (ICH) | Day 51 (ICANS) | Day 17 (PD) | Day 15 (HLH) |
| . | Patient 1 . | Patient 2 . | Patient 3 . | Patient 4 . | Patient 5 . | Patient 6 . | Patient 7 . | Patient 8 . |
|---|---|---|---|---|---|---|---|---|
| Age, y | 46 | 72 | 60 | 83 | 59 | 76 | 24 | 38 |
| Sex | Female | Male | Male | Male | Male | Female | Male | Female |
| ECOG PS | 1 | 2 | 0 | 2 | 0 | 1 | 1 | 3 |
| Histology | DLBCL | DLBCL | tFL | DLBCL | DLBCL | tFL | DLBCL | DLBCL |
| Ann Arbor stage | IV | III | IV | IV | IV | III | IV | IV |
| IPI score | 3 | 4 | 3 | 4 | 3 | 3 | 3 | 4 |
| Prior CNS lymphoma | No | No | No | Yes | No | No | No | No |
| Previous treatment | ||||||||
| Previous therapies, n | 2 | 2 | 6 | 3 | 3 | 3 | 3 | 4 |
| Refractory disease | No | No | Yes | Yes | No | Yes | Yes | Yes |
| Previous ASCT | Yes | Yes | Yes | No | Yes | No | No | No |
| Inflammatory and disease burden markers | ||||||||
| CRP, mg/L | 2 | 13 | 51 | 4 | 232 | 35 | 191 | 214 |
| Ferritin, mg/L | 1554 | 1135 | 3332 | 628 | 14 240 | 190 | 8718 | 6183 |
| LDH > ULN | No | No | No | No | Yes | No | Yes | Yes |
| Toxicity management | ||||||||
| Treated toxicity | ICANS G4 | ICANS G3 | ICANS G4 | ICANS G4 | ICANS G4 | ICANS G4 | HLH | HLH |
| Tocilizumab start | Day 4 | Day 5 | — | Day 4 | Day 4 | — | Day 3 | Day 11 |
| Tocilizumab dose | 8 mg/kg IV ×2 | 8 mg/kg IV ×2 | 0 | 8 mg/kg IV ×2 | 8 mg/kg IV ×2 | 0 | 8 mg/kg IV ×1 | 8 mg/kg IV ×2 |
| Corticosteroid start | Day 4 | Day 5 | Day 34 | Day 5 | Day 6 | Day 7 | Day 3 | Day 7 |
| Dexamethasone dose | 8-186 mg ×24 d | 1-186 mg ×57 d | 10 mg ×1 d | 40-186 mg ×13 d | 40-80 mg ×19 d | 4-186 mg ×35 d | 12-186 mg ×14 d | 40-80 mg ×9 d |
| Anakinra start | Day 6 | Day 41 | Day 31 | Day 7 | Day 10 | Day 31 | Day 7 | Day 14 |
| Anakinra dose | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 100 mg SC every other day ×5 | 100 mg SC daily ×7 | 100 mg SC daily ×7 | 200 mg SC daily ×1 |
| Response to anakinra | ||||||||
| Toxicity response | Yes (G0) | Yes (G1) | Yes (G0) | Yes (G2) | No | No | No | No |
| Toxicity recurrence | No | No | No | Yes | Yes | Yes | Yes | Yes |
| Day of death (cause) | — | Day 80 (pneumonia) | Day 71 (HLH) | Day 18 (PD) | Day 31 (ICH) | Day 51 (ICANS) | Day 17 (PD) | Day 15 (HLH) |
No patient had received previous CAR T-cell therapy or ASCT. Seven of 8 patients were admitted to an intensive care unit. One patient had not received corticosteroids, and 2 had not received tocilizumab before initiation of anakinra.
ASCT, autologous stem cell transplantation; CNS, central nervous system; DLBCL, diffuse LBCL; ECOG PS, European Cooperative Oncology Group performance status; G, grade; ICH, intracranial hemorrhage; IPI, International Prognostic Index; PD, progressive disease; tFL, transformed follicular lymphoma; ULN, upper limit of normal.