Late Immune Effector Cell-Associated Hematologic Toxicity After CD19 CAR-T Therapy: Incidence, Clinical Course, and...

Area of Science:

• Hematology
• Immunotherapy
• Oncology

Background:

• Chimeric antigen receptor T cells (CAR-T) therapy is a promising cancer treatment.
• Prolonged hematotoxicity, termed late immune effector cell-associated hematologic toxicity (ICAHT), is a known complication of CAR-T therapy.
• Limited data exists on the duration and clinical impact of late ICAHT.

Purpose of the Study:

• To investigate the incidence, duration, and clinical implications of late ICAHT following CD19-directed CAR-T therapy.
• To identify factors associated with the development of late ICAHT.
• To assess healthcare resource utilization associated with late ICAHT.

Main Methods:

• Retrospective review of 156 adult patients receiving CD19-directed CAR-T therapy.
• Analysis of ICAHT incidence and duration, with censoring for disease progression and death.
• Univariate analysis to identify predictors of late ICAHT and assessment of resource utilization in a subset of patients.

Main Results:

• Late ICAHT occurred in 39% of patients, with a median duration of 183 days and 20% lasting over 1 year.
• Overall survival was similar between patients with and without late ICAHT.
• HE মাটিতেOTOX score was significantly associated with late ICAHT development; growth factors were a primary cost driver, and patients required frequent healthcare encounters.

Conclusions:

• Late ICAHT is a common, usually self-limited toxicity following CAR-T therapy.
• Current definitions of late ICAHT (e.g., 30-day cutoff) may need re-evaluation to better capture its clinical impact.
• Further research is needed to optimize the characterization and management of late ICAHT and its associated healthcare utilization.