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ORIGINAL RESEARCH article

Front. Med.
Sec. Gene and Cell Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1465802
This article is part of the Research Topic Overcoming Side Effects in Patients Undergoing Immunotherapies and Cell Therapies: A Deeper Evaluation of Advanced Therapeutic Medicinal Products View all articles

A single center retrospective study on real world CAR T-cell Therapy: focus on early hematological toxicity

Provisionally accepted
Vadim Lesan Vadim Lesan *Konstantinos Christofyllakis Konstantinos Christofyllakis Moritz Bewarder Moritz Bewarder Lorenz Thurner Lorenz Thurner Joerg T. Bittenbring Joerg T. Bittenbring
  • Saarland University Hospital, Homburg, Germany

The final, formatted version of the article will be published soon.

    Patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL) and multiple myeloma have poor outcomes. CAR-T completely changed the landscape of therapy options, improving not only response rates but also survival outcomes. Hematological toxicity after chimeric antigen receptor therapy (CAR-T) is of increasing interest, being a recognized prognostic factor in this setting. We report our experience with early hematological toxicity after CAR-T therapy and point some important aspects regarding the Hematotox-Score. We identified a strong negative correlation between Hematotox-Score and platelet count at first day of cytokine release syndrome (CRS). Hematotox-Score was predictive of hemoglobin levels at day 28 after CAR-T. Ferritin remained high after 28 days post CAR-T in patients with high Hematotox-Score. Hematotox-Score did not associate with mortality in our cohort. We did not find any significant association between the hematological parameters (hemoglobin, platelets, and neutrophil counts), ferritin, LDH at first day of CRS and mortality. In conclusion, we demonstrate that Hematotox-Score is predictive of early hematological toxicity after CAR-T. Although, patients with higher degree of hematological toxicities have poorer survival outcomes, Hematotox-Score lacks predictive potential, probably due to its limitations. Further development of hematological scores predicting survival outcome in the context of CAR-T are needed.

    Keywords: Lymphoma, car-t, hematological toxicity Contributions Conceptualization: VL, JB, Writing-original draft: VL, Writing-review & editing: VL, kc, MB

    Received: 16 Jul 2024; Accepted: 06 Nov 2024.

    Copyright: © 2024 Lesan, Christofyllakis, Bewarder, Thurner and Bittenbring. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Vadim Lesan, Saarland University Hospital, Homburg, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.