Incidence of thrombosis in relapsed/refractory B-cell lymphoma treated with axicabtagene ciloleucel: Mayo Clinic experience

Megan Melody, Sangeetha Gandhi, Hollie Saunders, Zaid Abdel-Rahman, Jacquelyn Hastings, Paula Lengerke Diaz, Nicole Gannon, Tuan Truong, Matthew Hathcock, Arushi Khurana, Patrick Johnston, Stephen Ansell, Nora Bennani, Jonas Paludo, Jose Villasboas Bisneto, Yucai Wang, Allison Rosenthal, James Foran, Ernesto Ayala, Hemant S. MurthyVivek Roy, Januario E. Castro, Yi Lin, Mohamed A. Kharfan-Dabaja

Research output: Contribution to journalArticlepeer-review

Abstract

Chimeric antigen receptor (CAR) T-cell therapy is effective in relapsed/refractory large B-cell lymphoma and results in a unique toxicity profile, namely cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome. The hyper-inflammatory state associated with these toxicities has been suggested to increase the risk of thrombosis. We conducted a retrospective analysis of patients treated with axicabtagene ciloleucel (axi-cel) to assess the rate of thrombosis with axi-cel therapy from the time of CAR T-cell infusion until the end of hospitalization, when performed in the inpatient setting, or up to day +30 when performed in the outpatient setting. Ninety-two (95%) of 97 patients were hospitalized during axi-cel therapy and 85 (88%) developed CRS. Fifty-five patients (57%) received concurrent anticoagulation (53 as prophylaxis). Patients with prior VTE did not have progression or evidence of new VTE. Only 2 (2.1%) patients developed VTE. These results demonstrate a low-risk for thrombosis in axi-cel recipients.

Original languageEnglish (US)
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - 2022

Keywords

  • CAR T-cell
  • coagulopathy
  • cytokine release syndrome
  • lymphoma
  • thrombosis

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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