Impact of Rituximab and Corticosteroids on Late Cytopenias Post-Chimeric Antigen Receptor T Cell Therapy

Madiha Iqbal, Radhika Bansal, Farah Yassine, Sangeetha Gandhi, Allison Rosenthal, Muhamad Alhaj Moustafa, Zhuo Li, Emily C. Craver, Razan Mohty, Hemant Murthy, Ernesto Ayala, Han Tun, Javier Munoz, Januario Castro, Yi Lin, Mohamed A. Kharfan-Dabaja

Research output: Contribution to journalArticlepeer-review

Abstract

Chimeric antigen receptor (CAR) T cell therapy represents a significant advancement in the treatment of patients with relapsed/refractory B cell lymphoid malignancies. Cytokine release syndrome and immune effector cell-associated neurotoxicity represent the most acute serious adverse events post CAR T cell therapy but the occurrence and persistence of cytopenias post CAR T cell therapy represent a significant adverse event and a management challenge. While most patients typically recover blood counts by 30 days, a significant subset of patients have persistent or late cytopenias beyond 30 days. Patients receiving CAR T cell are heavily pre-treated and the impact of prior therapies on late cytopenias is not well understood. In this study, we found an association between increased number of rituximab infusions and/or cumulative rituximab dose received prior to CAR T cell infusion and persistent anemia and thrombocytopenia at 90 and 180 days afterwards. An overall increased number of prior lines of therapy was also associated with persistent lymphopenia and anemia at 90 days while receiving a prior autologous hematopoietic cell transplant was associated with a greater risk of neutropenia and lymphopenia.

Original languageEnglish (US)
JournalTransplantation and Cellular Therapy
DOIs
StateAccepted/In press - 2022

Keywords

  • Chimeric antigen receptor T cell therapy
  • Cytopenia
  • Lymphoma
  • Rituximab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Molecular Medicine
  • Hematology
  • Cell Biology
  • Transplantation

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