Acute and delayed cytopenias following CAR T-cell therapy: an investigation of risk factors and mechanisms. Issue 8 (3rd July 2022)

• Record Type: Journal Article
• Authors: Brudno, Jennifer N.; Natrakul, Danielle; Lam, Norris; Dulau-Florea, Alina; Yuan, Constance M.; Kochenderfer, James N.
• Is Part Of: Leukemia & lymphoma. Volume 63:Issue 8(2022)
• Page Start: 1849
• Page End: 1860
• Publication Date: 2022-07-03
• Subjects: Chimeric antigen receptor -- CAR T-cell -- hematologic malignancies -- cytopenia -- bone marrow suppression; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2022.2056172
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Prolonged myelosuppression after chimeric antigen receptor (CAR) T-cell therapy is common and poorly understood. A retrospective analysis of 43 patients was conducted to investigate factors contributing to CAR T-cell-related cytopenias. Thirty-five patients were evaluable for analysis of delayed cytopenias occurring after initial hematologic recovery. Time to hematologic recovery (TTHR) was defined as number of days after CAR T-cell infusion for recovery to hemoglobin ≥8.0 g/dL, platelets ≥50.0 k/µL, and neutrophil count ≥1.0 k/µL without transfusions or growth factors for 7 days. Baseline percent bone marrow (BM) malignancy involvement correlated with TTHR ( p = .0047). Patients with grades 3–4 cytokine-release syndrome (CRS) had longer TTHR than those with grades 0–2 CRS ( p = .0479). Patients who developed prolonged or delayed cytopenias after anti-BCMA CAR T cells had a higher percentage of BM aspirate CAR + cells at 2 months ( n = 10; p = .0159).