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New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia

Although chimeric antigen receptor T (CAR-T) cell therapy has proven to be effective in treating relapsed or refractory B-cell hematological malignancies, severe hematological toxicities remain an intractable issue. This retrospective study assessed the characteristics and risk factors of new-onset...

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Autores principales: Wang, Linqin, Hong, Ruimin, Zhou, Linghui, Ni, Fang, Zhang, Mingming, Zhao, Houli, Wu, Wenjun, Wang, Yiyun, Ding, Shuyi, Chang, Alex H., Hu, Yongxian, Huang, He
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278328/
https://www.ncbi.nlm.nih.gov/pubmed/34277448
http://dx.doi.org/10.3389/fonc.2021.702644
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author Wang, Linqin
Hong, Ruimin
Zhou, Linghui
Ni, Fang
Zhang, Mingming
Zhao, Houli
Wu, Wenjun
Wang, Yiyun
Ding, Shuyi
Chang, Alex H.
Hu, Yongxian
Huang, He
author_facet Wang, Linqin
Hong, Ruimin
Zhou, Linghui
Ni, Fang
Zhang, Mingming
Zhao, Houli
Wu, Wenjun
Wang, Yiyun
Ding, Shuyi
Chang, Alex H.
Hu, Yongxian
Huang, He
author_sort Wang, Linqin
collection PubMed
description Although chimeric antigen receptor T (CAR-T) cell therapy has proven to be effective in treating relapsed or refractory B-cell hematological malignancies, severe hematological toxicities remain an intractable issue. This retrospective study assessed the characteristics and risk factors of new-onset severe cytopenia following CAR-T cell infusion in 76 patients with r/r acute lymphoblastic leukemia. The rates of new-onset severe cytopenia were high, including severe neutropenia (SN) (39/56, 70%), severe anemia (SA) (35/66, 53%), and severe thrombocytopenia (ST) (31/64, 48%). Comparatively, cohorts with higher cytokine release syndrome (CRS) grades had higher incidence of severe cytopenia with prolonged duration. Multivariable analyses showed that elevated maximum (max) lg D-dimer and delayed peak time of CRS are independent risk factors for SN recovery; increased max lg IL-10 and delayed CRS recovery are risk factors for SA; high max lg ferritin is a risk factor for ST; and longer period to CRS onset or CRS recovery and higher grade of CRS are risk factors for prolonged hematological toxicities. These observations led to the conclusion that profiles of CRS, including its duration, severity and serum markers are correlated to the incidence and recovery of new-onset severe cytopenia, prompting clinical intervention for post-CAR-T severe cytopenia.
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spelling pubmed-82783282021-07-15 New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia Wang, Linqin Hong, Ruimin Zhou, Linghui Ni, Fang Zhang, Mingming Zhao, Houli Wu, Wenjun Wang, Yiyun Ding, Shuyi Chang, Alex H. Hu, Yongxian Huang, He Front Oncol Oncology Although chimeric antigen receptor T (CAR-T) cell therapy has proven to be effective in treating relapsed or refractory B-cell hematological malignancies, severe hematological toxicities remain an intractable issue. This retrospective study assessed the characteristics and risk factors of new-onset severe cytopenia following CAR-T cell infusion in 76 patients with r/r acute lymphoblastic leukemia. The rates of new-onset severe cytopenia were high, including severe neutropenia (SN) (39/56, 70%), severe anemia (SA) (35/66, 53%), and severe thrombocytopenia (ST) (31/64, 48%). Comparatively, cohorts with higher cytokine release syndrome (CRS) grades had higher incidence of severe cytopenia with prolonged duration. Multivariable analyses showed that elevated maximum (max) lg D-dimer and delayed peak time of CRS are independent risk factors for SN recovery; increased max lg IL-10 and delayed CRS recovery are risk factors for SA; high max lg ferritin is a risk factor for ST; and longer period to CRS onset or CRS recovery and higher grade of CRS are risk factors for prolonged hematological toxicities. These observations led to the conclusion that profiles of CRS, including its duration, severity and serum markers are correlated to the incidence and recovery of new-onset severe cytopenia, prompting clinical intervention for post-CAR-T severe cytopenia. Frontiers Media S.A. 2021-06-30 /pmc/articles/PMC8278328/ /pubmed/34277448 http://dx.doi.org/10.3389/fonc.2021.702644 Text en Copyright © 2021 Wang, Hong, Zhou, Ni, Zhang, Zhao, Wu, Wang, Ding, Chang, Hu and Huang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Wang, Linqin
Hong, Ruimin
Zhou, Linghui
Ni, Fang
Zhang, Mingming
Zhao, Houli
Wu, Wenjun
Wang, Yiyun
Ding, Shuyi
Chang, Alex H.
Hu, Yongxian
Huang, He
New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
title New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
title_full New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
title_fullStr New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
title_full_unstemmed New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
title_short New-Onset Severe Cytopenia After CAR-T Cell Therapy: Analysis of 76 Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
title_sort new-onset severe cytopenia after car-t cell therapy: analysis of 76 patients with relapsed or refractory acute lymphoblastic leukemia
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278328/
https://www.ncbi.nlm.nih.gov/pubmed/34277448
http://dx.doi.org/10.3389/fonc.2021.702644
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