Clinical characteristics and prognostic analysis of prolonged cytopenia after CAR-T cell therapy in LBCL patients
10.3760/cma.j.cn112138-20240713-00450
- VernacularTitle:大B细胞淋巴瘤CAR-T细胞治疗后延迟性血细胞减少的临床特征及预后分析
- Author:
Huiying ZHU
1
;
Danqing ZHAO
;
Zhe ZHUANG
;
Jing RUAN
;
Chao CHEN
;
Wei ZHANG
;
Daobin ZHOU
;
Yan ZHANG
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院血液内科，北京 100730
- Keywords:
Lymphoma, large B-cell;
Chimeric antigen receptor T cell therapy;
Cytopenia
- From:
Chinese Journal of Internal Medicine
2024;63(12):1238-1245
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical features and prognosis of prolonged cytopenia (PC) in patients with large B-cell lymphoma (LBCL) undergoing anti-CD19 chimeric antigen receptor T (CAR-T) cell therapy.Methods:A retrospective case series study was conducted on LBCL patients who received CAR-T cell therapy with a survival time of over one month at the Hematology Department of Peking Union Medical College Hospital from March 2019 to December 2023. Statistical analyses were performed on hematologic changes at 1, 3, 6, and 12 months post-CAR-T infusion, as well as on the progression-free survival (PFS) and post-treatment adverse events, including infections. Patients were categorized into the PC and non-PC groups based on the occurrence of cytopenia at 90 days post-infusion. Differences between groups were compared, and univariate logistic regression analysis was used to identify risk factors.Results:The median age of 27 LBCL patients receiving CAR-T cell therapy was 58 years (range 27-69 years), with 18 males. Among the 27 LBCL patients who received CAR-T cell therapy, PC was observed in 19 patients (70.4%), with instances of neutropenia (48.1%, 13 cases), anemia (37.0%, 10 cases), and thrombocytopenia (22.2%, 6 cases). Univariate logistic regression analysis revealed that prior chemotherapy sensitivity ( OR=18.00, 95% CI 1.56-207.45, P=0.020) and bone marrow suppression ( OR=18.00, 95% CI 1.38-235.69, P=0.028) were associated with PC. The median follow-up time was 13.5 months. The PC group exhibited a higher risk of infection within 3 months (9/19 vs. 1/8) and a shorter mean PFS (19.3 months vs. 24.4 months), although the difference was not statistically significant (both P>0.05). Conclusions:PC is common following CAR-T cell therapy and is associated with an increased risk of infection and poorer prognosis. Prior treatment sensitivity and bone marrow suppression may serve as indicators of PC.
