Cytopenias after cd19 chimeric antigen receptor t-cells (Car-t) therapy for diffuse large b-cell lymphomas or transformed follicular lymphoma: A single institution experience

Andrew Schaefer, Ying Huang, Adam Kittai, Joseph E. Maakaron, Caner Saygin, Jonathan Brammer, Sam Penza, Ayman Saad, Samantha M. Jaglowski, Basem M. William

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Introduction: Patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) have poor outcomes. Treatment with CD19 chimeric antigen receptor (CAR-T) cells, tisa-genlecleucel and axicabtagene ciloleucel, has been associated with improved outcomes. Cytopenias were observed in clinical trials with both products; however, little is known regarding the patterns and outcomes of these cytopenias. Subjects and Methods: We reviewed DLBCL patients (n=32) receiving either product between January and September 2018 at our institution. Results: Median duration of leukopenia, neutropenia, lymphopenia, anemia, and thrombo-cytopenia was 49, 9, 117.5, 125, and 95.5 days after CAR-T infusion, respectively. Filgrastim was used in 63% of patients, and 50% of patients received red cell or platelet transfusions. With the exception of neutropenia, increase in the duration of cytopenia of any lineage was associated with improvement in progression-free survival, and in overall survival in case of anemia. There was no association between the duration of cytopenias with either cytokine release syndrome or neurotoxicity. Discussion: Our data suggest a correlation between cytopenias and survival outcomes after CD19 CAR-T therapy. If validated, cytopenia may be proven useful as a biomarker of response and survival after CAR-T therapy.

Original languageEnglish (US)
Pages (from-to)8901-8906
Number of pages6
JournalCancer Management and Research
Volume13
DOIs
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 Schaefer et al.

Keywords

  • Chimeric antigen receptor T-cells
  • Cytopenias
  • Diffuse large B-cell lymphoma
  • Immunotherapy
  • Transformed follicular lymphomas

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