Immune Effector Cell-Associated Hematotoxicity With Secondary Myelofibrosis Following Idecabtagene-Vicleucel for
Keishi Ogura1, Takahiro Fujino1, Takahisa Nakamura1
1Division of Hematology and Oncology Department of Medicine Kyoto Prefectural University of Medicine Kyoto Japan.
Pancytopenia accompanied by chimeric antigen receptor T cell (CAR-T) therapy is termed immune effector cell-associated hematopoietic toxicity (ICAHT), which is often sustained and refractory to supportive care. We report a case of a 52-year-old man with multiple myeloma who developed severe ICAHT with secondary myelofibrosis (sMF) after administration of idecabtagene-vicleucel, which was comprehensively improved by autologous hematopoietic stem cell boosting. This case focuses on sMF as a rare but cautionary complication of CAR-T therapy, underscoring the importance of bone marrow biopsy to exclude sMF and of stem cell boosting for the treatment of persistent ICAHT.
Pancytopenia accompanied by chimeric antigen receptor T cell (CAR-T) therapy is termed immune effector cell-associated hematopoietic toxicity (ICAHT), which is often sustained and refractory to supportive care. We report a case of a 52-year-old man with multiple myeloma who developed severe ICAHT with secondary myelofibrosis (sMF) after administration of idecabtagene-vicleucel, which was comprehensively improved by autologous hematopoietic stem cell boosting. This case focuses on sMF as a rare but cautionary complication of CAR-T therapy, underscoring the importance of bone marrow biopsy to exclude sMF and of stem cell boosting for the treatment of persistent ICAHT.
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