Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience

Andrew Schaefer,1 Ying Huang,2 Adam Kittai,2 Joseph E Maakaron,3 Caner Saygin,4 Jonathan Brammer,2 Sam Penza,2 Ayman Saad,2 Samantha M Jaglowski,2 Basem M William5 1Department of Medicine, University of Wisconsin, Madison, WI, USA; 2Department of Internal Medicine, The Ohio State University, Columbu...

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Autores principales:	Schaefer A, Huang Y, Kittai A, Maakaron JE, Saygin C, Brammer J, Penza S, Saad A, Jaglowski SM, William BM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diffuse large b-cell lymphoma transformed follicular lymphomas chimeric antigen receptor t-cells immunotherapy cytopenias Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/058e8dcd42a74747943e4a3367543dde
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spelling	oai:doaj.org-article:058e8dcd42a74747943e4a3367543dde2021-11-30T18:50:36ZCytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience1179-1322https://doaj.org/article/058e8dcd42a74747943e4a3367543dde2021-11-01T00:00:00Zhttps://www.dovepress.com/cytopenias-after-cd19-chimeric-antigen-receptor-t-cells-car-t-therapy--peer-reviewed-fulltext-article-CMARhttps://doaj.org/toc/1179-1322Andrew Schaefer,1 Ying Huang,2 Adam Kittai,2 Joseph E Maakaron,3 Caner Saygin,4 Jonathan Brammer,2 Sam Penza,2 Ayman Saad,2 Samantha M Jaglowski,2 Basem M William5 1Department of Medicine, University of Wisconsin, Madison, WI, USA; 2Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; 3Department of Medicine, University of Minnesota, Minneapolis, MN, USA; 4Department of Medicine, University of Chicago, Chicago, IL, USA; 5OhioHealth Blood and Marrow Transplant Program, Columbus, OH, USACorrespondence: Basem M WilliamOhioHealth Blood and Marrow Transplant Program, 500 Thomas Lane, Columbus, OH, 43214, USAEmail basemmwilliam@gmail.comIntroduction: Patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) have poor outcomes. Treatment with CD19 chimeric antigen receptor (CAR-T) cells, tisagenlecleucel and axicabtagene ciloleucel, has been associated with improved outcomes. Cytopenias were observed in clinical trials with both products; however, little is known regarding the patterns and outcomes of these cytopenias.Subjects and Methods: We reviewed DLBCL patients (n=32) receiving either product between January and September 2018 at our institution.Results: Median duration of leukopenia, neutropenia, lymphopenia, anemia, and thrombocytopenia was 49, 9, 117.5, 125, and 95.5 days after CAR-T infusion, respectively. Filgrastim was used in 63% of patients, and 50% of patients received red cell or platelet transfusions. With the exception of neutropenia, increase in the duration of cytopenia of any lineage was associated with improvement in progression-free survival, and in overall survival in case of anemia. There was no association between the duration of cytopenias with either cytokine release syndrome or neurotoxicity.Discussion: Our data suggest a correlation between cytopenias and survival outcomes after CD19 CAR-T therapy. If validated, cytopenia may be proven useful as a biomarker of response and survival after CAR-T therapy.Keywords: diffuse large B-cell lymphoma, transformed follicular lymphomas, chimeric antigen receptor T-cells, immunotherapy, cytopeniasSchaefer AHuang YKittai AMaakaron JESaygin CBrammer JPenza SSaad AJaglowski SMWilliam BMDove Medical Pressarticlediffuse large b-cell lymphomatransformed follicular lymphomaschimeric antigen receptor t-cellsimmunotherapycytopeniasNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Management and Research, Vol Volume 13, Pp 8901-8906 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diffuse large b-cell lymphoma transformed follicular lymphomas chimeric antigen receptor t-cells immunotherapy cytopenias Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	diffuse large b-cell lymphoma transformed follicular lymphomas chimeric antigen receptor t-cells immunotherapy cytopenias Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Schaefer A Huang Y Kittai A Maakaron JE Saygin C Brammer J Penza S Saad A Jaglowski SM William BM Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience
description	Andrew Schaefer,1 Ying Huang,2 Adam Kittai,2 Joseph E Maakaron,3 Caner Saygin,4 Jonathan Brammer,2 Sam Penza,2 Ayman Saad,2 Samantha M Jaglowski,2 Basem M William5 1Department of Medicine, University of Wisconsin, Madison, WI, USA; 2Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; 3Department of Medicine, University of Minnesota, Minneapolis, MN, USA; 4Department of Medicine, University of Chicago, Chicago, IL, USA; 5OhioHealth Blood and Marrow Transplant Program, Columbus, OH, USACorrespondence: Basem M WilliamOhioHealth Blood and Marrow Transplant Program, 500 Thomas Lane, Columbus, OH, 43214, USAEmail basemmwilliam@gmail.comIntroduction: Patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) have poor outcomes. Treatment with CD19 chimeric antigen receptor (CAR-T) cells, tisagenlecleucel and axicabtagene ciloleucel, has been associated with improved outcomes. Cytopenias were observed in clinical trials with both products; however, little is known regarding the patterns and outcomes of these cytopenias.Subjects and Methods: We reviewed DLBCL patients (n=32) receiving either product between January and September 2018 at our institution.Results: Median duration of leukopenia, neutropenia, lymphopenia, anemia, and thrombocytopenia was 49, 9, 117.5, 125, and 95.5 days after CAR-T infusion, respectively. Filgrastim was used in 63% of patients, and 50% of patients received red cell or platelet transfusions. With the exception of neutropenia, increase in the duration of cytopenia of any lineage was associated with improvement in progression-free survival, and in overall survival in case of anemia. There was no association between the duration of cytopenias with either cytokine release syndrome or neurotoxicity.Discussion: Our data suggest a correlation between cytopenias and survival outcomes after CD19 CAR-T therapy. If validated, cytopenia may be proven useful as a biomarker of response and survival after CAR-T therapy.Keywords: diffuse large B-cell lymphoma, transformed follicular lymphomas, chimeric antigen receptor T-cells, immunotherapy, cytopenias
format	article
author	Schaefer A Huang Y Kittai A Maakaron JE Saygin C Brammer J Penza S Saad A Jaglowski SM William BM
author_facet	Schaefer A Huang Y Kittai A Maakaron JE Saygin C Brammer J Penza S Saad A Jaglowski SM William BM
author_sort	Schaefer A
title	Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience
title_short	Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience
title_full	Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience
title_fullStr	Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience
title_full_unstemmed	Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience
title_sort	cytopenias after cd19 chimeric antigen receptor t-cells (car-t) therapy for diffuse large b-cell lymphomas or transformed follicular lymphoma: a single institution experience
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/058e8dcd42a74747943e4a3367543dde
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Cytopenias After CD19 Chimeric Antigen Receptor T-Cells (CAR-T) Therapy for Diffuse Large B-Cell Lymphomas or Transformed Follicular Lymphoma: A Single Institution Experience

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