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 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 October 2020 -- Source: Scopus |
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