CT-CI Calculator

CAR-T Cells

Cellular Therapy Comorbidity Index (CT-CI)

The cumulative impact of baseline comorbidities on outcomes of chimeric antigen receptor T cell (CAR-T) therapy is not well-established. The affiliated study was the genesis for a Cellular Therapy Comorbidity Index (CT-CI) to predict outcomes following CD19-directed CAR-T therapy for the treatment of large B-cell lymphoma (LBCL).

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Calculate a Cellular Therapy Comorbidity Index (CT-CI) to predict outcomes following CD19-directed CAR-T therapy

Cellular Therapy Comorbidity Index (CT-CI)

The CT-CI was developed and validated only in patients aged 18 or older receiving commercial CAR-T therapy, including tisa-cel and axi-cel, for LBCL (see Notes below). Please hover over the This icon shows help text when you hover over it

for additional clinical details related to the severity of comorbidities included in the tool below.

Diagnosis of LBCL (Large B-cell Lymphoma) Diagnosis of LBCL

Age Age >18 years

CAR-T: Chimeric Antigen Receptor T-cell,
Tisa-cel: Tisagenlecleucel;
Axi-cel: Axicabtagene Ciloleucel; CAR-T product

Diabetes

CVA: Cerebrovascular Accident;
TIA: Transient Ischemic Attack; Cerebrovascular Disease

BMI: Body Mass Index BMI <20 kg/m2

[SEVERE]: corrected DLCO and/or FEV1 of <65% or dyspnea at rest attributed to pulmonary disease or the need for intermittent or continuous oxygen during the 4 weeks prior to CAR-T Pulmonary disease

[MODERATE / SEVERE]: creatinine >2 mg/dL (>177 umol/L); on dialysis during the 4 weeks prior to CAR-T OR prior renal transplantation Renal disease

Infection requiring antimicrobial treatment after Day of HCT

[MILD]: bilirubin >ULN to 1.5x ULN, AST/ALT > ULN to 2.5x ULN at the time of CAR-T OR any history of Hepatits B or Hepatitis C infection
[MODERATE / SEVERE]: Liver cirrhosis, bilirubin >1.5x ULN, or AST/ALT >2.5x ULN Hepatic disease

Abbreviations: LBCL: large B-cell lymphoma; CAR-T, chimeric antigen receptor T cell, Tisa-cel, Tisagenlecleucel; Axi-cel, Axicabtagene ciloleucel; CVA, Cerebrovascular accident; TIA, Transient ischemic attack; BMI, Body Mass Index; DLCO: Diffusion capacity of carbon monoxide; FEV1, Forced expiratory volume in one second; ULN, upper limit of normal; AST, Aspartate aminotransferase; ALT, alanine aminotransferase

Cellular Therapy Comorbidity Index (CT-CI) Score

Note:

The CT-CI was developed by Greenbaum et al., using the CIBMTR registry as part of the Cellular Immunotherapy for Cancer Working Committee (CICWC) study CT-2003. The full publication, “Development of a Comorbidity Index to Predict Survival After Chimeric Antigen Receptor T Cell Therapy for Large B-Cell Lymphoma” can be found here: https://orcid.org/0000-0002-5110-004X.

Patients aged 18 or older receiving commercial CAR-T therapy, including tisa-cel and axi-cel, for LBCL during 2017-2020 were identified from the CIBMTR registry. Patients were randomly assigned to a training and validation cohort. Comorbidities were given weighted scores comprising the CT-CI, which was then validated for overall survival (OS) prognostication.