Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEG
Abstract Objective To develop an automated, physiologic metric of immune effector cell‐associated neurotoxicity syndrome among patients undergoing chimeric antigen receptor‐T cell therapy. Methods We conducted a retrospective observational cohort study from 2016 to 2020 at two tertiary care centers...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51866 |
| _version_ | 1797659125441626112 |
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| author | Christine A. Eckhardt Haoqi Sun Preeti Malik Syed Quadri Marcos Santana Firme Daniel K. Jones Meike vanSleuwen Aayushee Jain Ziwei Fan Jin Jing Wendong Ge Husain H. Danish Caron A. Jacobson Daniel B. Rubin Eyal Y. Kimchi Sydney S. Cash Matthew J. Frigault Jong Woo Lee Jorg Dietrich M. Brandon Westover |
| author_facet | Christine A. Eckhardt Haoqi Sun Preeti Malik Syed Quadri Marcos Santana Firme Daniel K. Jones Meike vanSleuwen Aayushee Jain Ziwei Fan Jin Jing Wendong Ge Husain H. Danish Caron A. Jacobson Daniel B. Rubin Eyal Y. Kimchi Sydney S. Cash Matthew J. Frigault Jong Woo Lee Jorg Dietrich M. Brandon Westover |
| author_sort | Christine A. Eckhardt |
| collection | DOAJ |
| description | Abstract Objective To develop an automated, physiologic metric of immune effector cell‐associated neurotoxicity syndrome among patients undergoing chimeric antigen receptor‐T cell therapy. Methods We conducted a retrospective observational cohort study from 2016 to 2020 at two tertiary care centers among patients receiving chimeric antigen receptor‐T cell therapy with a CD19 or B‐cell maturation antigen ligand. We determined the daily neurotoxicity grade for each patient during EEG monitoring via chart review and extracted clinical variables and outcomes from the electronic health records. Using quantitative EEG features, we developed a machine learning model to detect the presence and severity of neurotoxicity, known as the EEG immune effector cell‐associated neurotoxicity syndrome score. Results The EEG immune effector cell‐associated neurotoxicity syndrome score significantly correlated with the grade of neurotoxicity with a median Spearman's R2 of 0.69 (95% CI of 0.59–0.77). The mean area under receiving operator curve was greater than 0.85 for each binary discrimination level. The score also showed significant correlations with maximum ferritin (R2 0.24, p = 0.008), minimum platelets (R2 –0.29, p = 0.001), and dexamethasone usage (R2 0.42, p < 0.0001). The score significantly correlated with duration of neurotoxicity (R2 0.31, p < 0.0001). Interpretation The EEG immune effector cell‐associated neurotoxicity syndrome score possesses high criterion, construct, and predictive validity, which substantiates its use as a physiologic method to detect the presence and severity of neurotoxicity among patients undergoing chimeric antigen receptor T‐cell therapy. |
| first_indexed | 2024-03-11T18:09:24Z |
| format | Article |
| id | doaj.art-931eebd756094e1289ead7d2678ffb8b |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-03-11T18:09:24Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-931eebd756094e1289ead7d2678ffb8b2023-10-16T20:02:29ZengWileyAnnals of Clinical and Translational Neurology2328-95032023-10-0110101776178910.1002/acn3.51866Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEGChristine A. Eckhardt0Haoqi Sun1Preeti Malik2Syed Quadri3Marcos Santana Firme4Daniel K. Jones5Meike vanSleuwen6Aayushee Jain7Ziwei Fan8Jin Jing9Wendong Ge10Husain H. Danish11Caron A. Jacobson12Daniel B. Rubin13Eyal Y. Kimchi14Sydney S. Cash15Matthew J. Frigault16Jong Woo Lee17Jorg Dietrich18M. Brandon Westover19Department of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADana Farber Cancer Institute Boston Massachusetts 02115 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USAHarvard Medical School Boston Massachusetts 02115 USAHarvard Medical School Boston Massachusetts 02115 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USADepartment of Neurology Massachusetts General Hospital Boston Massachusetts 02114 USAAbstract Objective To develop an automated, physiologic metric of immune effector cell‐associated neurotoxicity syndrome among patients undergoing chimeric antigen receptor‐T cell therapy. Methods We conducted a retrospective observational cohort study from 2016 to 2020 at two tertiary care centers among patients receiving chimeric antigen receptor‐T cell therapy with a CD19 or B‐cell maturation antigen ligand. We determined the daily neurotoxicity grade for each patient during EEG monitoring via chart review and extracted clinical variables and outcomes from the electronic health records. Using quantitative EEG features, we developed a machine learning model to detect the presence and severity of neurotoxicity, known as the EEG immune effector cell‐associated neurotoxicity syndrome score. Results The EEG immune effector cell‐associated neurotoxicity syndrome score significantly correlated with the grade of neurotoxicity with a median Spearman's R2 of 0.69 (95% CI of 0.59–0.77). The mean area under receiving operator curve was greater than 0.85 for each binary discrimination level. The score also showed significant correlations with maximum ferritin (R2 0.24, p = 0.008), minimum platelets (R2 –0.29, p = 0.001), and dexamethasone usage (R2 0.42, p < 0.0001). The score significantly correlated with duration of neurotoxicity (R2 0.31, p < 0.0001). Interpretation The EEG immune effector cell‐associated neurotoxicity syndrome score possesses high criterion, construct, and predictive validity, which substantiates its use as a physiologic method to detect the presence and severity of neurotoxicity among patients undergoing chimeric antigen receptor T‐cell therapy.https://doi.org/10.1002/acn3.51866 |
| spellingShingle | Christine A. Eckhardt Haoqi Sun Preeti Malik Syed Quadri Marcos Santana Firme Daniel K. Jones Meike vanSleuwen Aayushee Jain Ziwei Fan Jin Jing Wendong Ge Husain H. Danish Caron A. Jacobson Daniel B. Rubin Eyal Y. Kimchi Sydney S. Cash Matthew J. Frigault Jong Woo Lee Jorg Dietrich M. Brandon Westover Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEG Annals of Clinical and Translational Neurology |
| title | Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEG |
| title_full | Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEG |
| title_fullStr | Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEG |
| title_full_unstemmed | Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEG |
| title_short | Automated detection of immune effector cell‐associated neurotoxicity syndrome via quantitative EEG |
| title_sort | automated detection of immune effector cell associated neurotoxicity syndrome via quantitative eeg |
| url | https://doi.org/10.1002/acn3.51866 |
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