Cytopenia after CAR‑T cell therapy: Analysis of 63 patients with relapsed and refractory B‑cell non‑Hodgkin lymphoma

Abstract

The present study aimed to determine the clinical characteristics of cytopenia in patients with relapsed and refractory B-cell non-Hodgkin lymphoma (B-NHL) who were treated with chimeric antigen receptor T-cell (CAR-T) therapy. Thus, a total of 63 patients with relapsed and refractory B-NHL who underwent CAR-T therapy between March 2017 and October 2021 were retrospectively selected for analysis. Neutropenia, anemia and thrombocytopenia at grade ≥3 occurred in 48 (76.19%), 16 (25.39%) and 15 (23.80%) cases, respectively. The results of a multivariate analysis demonstrated that the baseline absolute neutrophil count (ANC) and hemoglobin concentration were independent risk factors for grade ≥3 cytopenia. A total of 3 patients died early and were therefore excluded from the present study. Furthermore, cell recovery was examined at day +28 after infusion; 21 patients (35%) did not recover from cytopenia and 39 patients (65%) recovered. A multivariate analysis demonstrated that the baseline ANC <2.29x10 9 /l, baseline hemoglobin <114.50 g/l and baseline IL-6 >21.43 pg/l were independent risk factors affecting hemocyte recovery. In conclusion, patients with relapsed and refractory B-NHL exhibited an increased incidence of grade ≥3 hematologic toxicity following CAR-T cell therapy, while baseline blood cell and IL-6 levels are independent risk factors for hemocyte recovery.

Infectious complications in pediatric patients undergoing CD19+CD22+ chimeric antigen receptor T-cell therapy for relapsed/refractory B-lymphoblastic leukemia

“…Neutropenia is an important risk factor for bacterial infection, and early bacterial infection with CAR-T therapy may be related to multiple neutropenic episodes during this period. Neutropenia is more common after CAR-T therapy, which can be caused by many factors (including CRS and LD chemotherapy) [14,[18][19][20]. In a clinical study of CAR-T therapy in patients with relapsed/refractory lymphoma, the incidence of neutropenia was 71%, and most of these cases (98%) occurred in the early phase after CAR-T therapy [21].…”