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Management of prolonged cytopenia following CAR T-cell therapy

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Fig. 1: Patient’ response to Romiplostim treatment.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Locke FL, Ghobadi A, Jacobson CA, Miklos DB, Lekakis LJ, Oluwole OO, et al. Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1-2 trial. Lancet Oncol. 2019;20:31–42.

    CAS  Article  Google Scholar 

  2. Schuster SJ, Bishop MR, Tam CS, Waller EK, Borchmann P, McGuirk JP, et al. Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma. N. Engl J Med. 2019;380:45–56.

    CAS  Article  Google Scholar 

  3. Neelapu SS, Locke FL, Bartlett NL, Lekakis LJ, Miklos DB, Jacobson CA, et al. Axicabtagene Ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. N. Engl J Med. 2017;377:2531–44.

    CAS  Article  Google Scholar 

  4. Abramson JS, Palomba ML, Gordon LI, Lunning MA, Wang M, Arnason J, et al. Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study. Lancet 2020;396:839–52.

    Article  Google Scholar 

  5. Jain T, Knezevic A, Pennisi M, Chen Y, Ruiz JD, Purdon TJ, et al. Hematopoietic recovery in patients receiving chimeric antigen receptor T-cell therapy for hematologic malignancies. Blood Adv. 2020;4:3776–87.

    CAS  Article  Google Scholar 

  6. Rejeski K, Perez A, Sesques P, Hoster E, Berger C, Jentzsch L, et al. CAR-HEMATOTOX: a model for CAR T-cell-related hematologic toxicity in relapsed/refractory large B-cell lymphoma. Blood 2021;138:2499–513.

    CAS  Article  Google Scholar 

  7. Fried S, Avigdor A, Bielorai B, Meir A, Besser MJ, Schachter J, et al. Early and late hematologic toxicity following CD19 CAR-T cells. Bone Marrow Transpl. 2019;54:1643–50.

    CAS  Article  Google Scholar 

  8. Kuter DJ, Rummel M, Boccia R, Macik BG, Pabinger I, Selleslag D, et al. Romiplostim or standard of care in patients with immune thrombocytopenia. N. Engl J Med. 2010;363:1889–99.

    CAS  Article  Google Scholar 

  9. Jang JH, Tomiyama Y, Miyazaki K, Nagafuji K, Usuki K, Uoshima N, et al. Efficacy and safety of romiplostim in refractory aplastic anaemia: a Phase II/III, multicentre, open-label study. Br J Haematol. 2021;192:190–9.

    CAS  Article  Google Scholar 

  10. Giammarco S, Sica S, Chiusolo P, Laurenti L, Sora F, Martino M, et al. Eltrombopag for the treatment of poor graft function following allogeneic stem cell transplant: a retrospective multicenter study. Int J Hematol. 2021;114:228–34.

    CAS  Article  Google Scholar 

  11. Neelapu SS. Managing the toxicities of CAR T-cell therapy. Hematol Oncol. 2019;37:48–52.

    CAS  Article  Google Scholar 

  12. Hashmi H, Shockley A, Davis JA. ‘Save the day with a Stem Cell Rescue’: Use of autologous hematopoietic stem cell boost for hematopoietic recovery after CAR T cell therapy. Bone Marrow Transpl. 2022;57:504–6.

    Article  Google Scholar 

Download references

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Authors and Affiliations

Authors

Contributions

All authors designed and conceptualized the project. MC, AA and RS collected the data. All authors wrote and edited the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Parastoo B. Dahi.

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Competing interests

RS- consultancy to Medxus and MyBiotics. MAP- honoraria from Abbvie, Allovir, Astellas, Bristol-Myers Squibb, Caribou Biosciences, Celgene, Equilium, Exevir, Incyte, Karyopharm, Kite/Gilead, Merck, Miltenyi Biotec, MorphoSys, Novartis, Nektar Therapeutics, Omeros, OrcaBio, Takeda, and VectivBio AG, Vor Biopharma. He serves on DSMBs for Cidara Therapeutics, Medigene, Sellas Life Sciences, and Servier, and the scientific advisory board of NexImmune. He has ownership interests in NexImmune and Omeros. He has received institutional research support for clinical trials from Incyte, Kite/Gilead, Miltenyi Biotec, Nektar Therapeutics, and Novartis. He serves in a volunteer capacity as a member of the Board of Directors of the American Society for Transplantation and Cellular Therapy (ASTCT) and on the CIBMTR Cellular Immunotherapy Data Resource (CIDR) Executive Committee, and previously served on the Board of Directors of Be The Match (National Marrow Donor Program, NMDP). GS- research funding to the institution from Janssen, Amgen and Beyond Spring.

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Corona, M., Shouval, R., Alarcón, A. et al. Management of prolonged cytopenia following CAR T-cell therapy. Bone Marrow Transplant (2022). https://doi.org/10.1038/s41409-022-01771-x

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