Hematopoietic recovery in patients receiving chimeric antigen receptor T-cell therapy for hematologic malignancies Journal Article

Authors: Jain, T.; Knezevic, A.; Pennisi, M.; Chen, Y.; Ruiz, J. D.; Purdon, T. J.; Devlin, S. M.; Smith, M.; Shah, G. L.; Halton, E.; Diamonte, C.; Scordo, M.; Sauter, C. S.; Mead, E.; Santomasso, B. D.; Palomba, M. L.; Batlevi, C. W.; Maloy, M. A.; Giralt, S.; Smith, E.; Brentjens, R.; Park, J. H.; Perales, M. A.; Mailankody, S.
Article Title: Hematopoietic recovery in patients receiving chimeric antigen receptor T-cell therapy for hematologic malignancies
Abstract: Factors contributing to hematopoietic recovery following chimeric antigen receptor (CAR) T-cell therapy have not been well studied. In an analysis of 83 patients with hematologic malignancies treated with CAR T-cell therapy, we describe patterns of hematopoietic recovery and evaluate potentially associated factors. We included patients who received axicabtagene ciloleucel (n = 30) or tisagenlecleucel (n = 10) for B-cell lymphoma, CD19-28z CAR T therapy for B-cell acute lymphoblastic leukemia (NCT01044069; n = 37), or B-cell maturation antigen targeting CAR T cells for multiple myeloma (NCT03070327; n = 6). Patients treated with CAR T cells who had not progressed, died, or received additional chemotherapy had "recovered"(per definition in Materials and methods section) hemoglobin, platelet, neutrophil, and white blood cell counts at rates of 61%, 51%, 33%, and 28% at month 1 postinfusion and 93%, 90%, 80%, and 59% at month 3 postinfusion, respectively. Univariate analysis showed that increasing grade of immune effector cell-associated neurological syndrome (ICANS), baseline cytopenias, CAR construct, and higher peak C-reactive protein or ferritin levels were statistically significantly associated with a lower likelihood of complete count recovery at 1 month; a similar trend was seen for cytokine release syndrome (CRS). After adjustment for baseline cytopenia and CAR construct, grade ≥3 CRS or ICANS remained significantly associated with the absence of complete count recovery at 1 month. Higher levels of vascular endothelial growth factor and macrophage-derived chemokines, although not statistically significant, were seen patients without complete count recovery at 1 month. This remains to be studied further in larger prospective studies. © 2020 by The American Society of Hematology.
Journal Title: Blood Advances
Volume: 4
Issue: 15
ISSN: 2473-9529
Publisher: American Society of Hematology  
Date Published: 2020-08-11
Start Page: 3776
End Page: 3787
Language: English
DOI: 10.1182/bloodadvances.2020002509
PUBMED: 32780846
PROVIDER: scopus
PMCID: PMC7422135
Notes: Article -- Export Date: 1 October 2020 -- Source: Scopus
Citation Impact
MSK Authors
  1. Renier J Brentjens
    265 Brentjens
  2. Maria Lia Palomba
    228 Palomba
  3. Sergio Andres Giralt
    754 Giralt
  4. Jae Hong Park
    219 Park
  5. Craig Steven Sauter
    259 Sauter
  6. Miguel-Angel Perales
    584 Perales
  7. Elizabeth F Halton
    46 Halton
  8. Molly Anna Maloy
    246 Maloy
  9. Sean McCarthy Devlin
    442 Devlin
  10. Michael Scordo
    141 Scordo
  11. Connie Wing-Ching Lee
    110 Lee
  12. Eric Smith
    67 Smith
  13. Melody Smith
    26 Smith
  14. Terence John Purdon
    58 Purdon
  15. Gunjan Lalitchandra Shah
    183 Shah
  16. Elena   Mead
    41 Mead
  17. Tania Jain
    25 Jain
  18. Josel Dumo Ruiz
    32 Ruiz
  19. Martina Pennisi
    22 Pennisi
  20. Yunxin Chen
    2 Chen