Hematological toxicity (hematotoxicity) leading to peripheral cytopenias is a common long‐term adverse effect following the use of CD19‐chimeric antigen receptor (CD19‐CAR) T‐cell therapies. However, management remains unclear for patients whose cytopenias persist beyond 1 month after CAR T‐cell infusion. We present the case of a 21‐year old who received CD19‐CAR T‐cell therapy for relapse following a haploidentical transplant. He developed hematotoxicity and consequently multiple life‐threatening infections. We administered a CD34+ hematopoietic stem cell boost (HSCB) from his transplant donor, which led to hematopoietic recovery and resolution of his infections without any effect on the activity of CD19‐CAR T cells. CD34+ HSCB can be a safe and effective option to treat hematotoxicity following CD19‐CAR T‐cell therapy.
Hematological toxicity (hematotoxicity) is the most common long-term
adverse effect following the use of CD19-chimeric antigen receptor
(CD19-CAR) T-cell therapies. However, its management remains unclear. We
present the case of a 21-year-old who received CD19-CAR T-cell therapy
for relapse following a haploidentical transplant. He developed
hematotoxicity and consequently multiple life-threatening infections. We
administered a CD34+ hematopoietic stem cell boost (HSCB) from his
transplant donor that led to hematopoietic recovery and resolution of
his infections without any effect on the activity of CD19-CAR T cells.
CD34+ HSCB can be a safe and effective option to treat hematotoxicity
following CD19-CAR T-cell therapy.
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