Dermatologic Adverse Events Following CD19-Directed CAR T-Cell Therapy in Hematologic Malignancies

Area of Science:

• Oncology
• Immunotherapy
• Dermatology

Background:

• CD19 CAR T-cell therapy represents a major advancement for treating B-cell hematologic malignancies like B-NHL and ALL.
• Understanding the spectrum and timing of dermatologic adverse events (dAEs) is crucial for managing patients undergoing this therapy.

Purpose of the Study:

• To characterize the incidence, onset, and contributing factors of dAEs following CD19 CAR T-cell therapy.
• To investigate the association between dAEs and systemic toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).

Main Methods:

• Retrospective analysis of 193 patients treated with CD19 CAR T-cell therapy at Memorial Sloan Kettering Cancer Center (April 2013 - August 2020).
• Evaluation of dAEs within the first 100 days, including cumulative incidence and time to onset.
• Assessment of correlations between dAEs, CRS, and ICANS.

Main Results:

• The 100-day cumulative incidence of dAEs was 0.42 (95% CI: 0.36-0.51), with 82 patients experiencing 94 events.
• Common dAEs included rash (30.9%), infections (23.4%), and xerosis (16.0%).
• CRS preceded dAEs in 86% of co-occurring cases, and ICANS preceded dAEs in 67% of cases.

Conclusions:

• dAEs are frequent following CAR T-cell therapy but are typically low-grade.
• The majority of dAEs manifest within the first month post-infusion, with varied onset times for specific events.