Research progress in cytopenia after CAR-T cell therapy for hematological malignancies
The effectiveness of chimeric antigen receptor(CAR)T cells in the treatment of hematological tumors is obvious.CAR-T related adverse effects include cytokine release syndrome(CRS),immune effector cell associated neurotoxicity syndrome,and hematological toxicity.Hematological toxicity after CAR-T is the most common grade 3 or higher adverse event in patients with multiple myeloma,B-cell lymphoma,and acute leukemia.It is influenced by CRS and CRS related cytokines,bone marrow function,CAR-T structure,lymphodepletion chemotherapy,baseline absolute neutrophil count(ANC),baseline hemoglobin(Hb),baseline platelet,ferritin peak,previous therapy lines and previous hematopoietic stem cell transplantation.Hematologic toxicity affects the prognosis of patients,shortens progression free survival and overall survival,increases the risk of infection and mortality.Before CAR-T infusion,the CAR-HEMATOTOX scoring model could be used for evaluating hemato-logic toxicity.After infusion,ICAHT grading management could be carried out according to the latest published consensus on CAR-T related hematotoxicity(ICAHT),to improve the survival and prognosis of patient.
chimeric antigen receptor T cellhematological malignanciescytopenias