Hematopoiesis and immune reconstitution after CD19 directed chimeric antigen receptor T-cells (CAR-T): A comprehensive review on incidence, risk factors and current management.
Eur J Haematol
; 112(2): 184-196, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37491951
ABSTRACT
Impaired function of hematopoiesis after treatment with chimeric antigen T-cells (CAR-T) is a frequent finding and can interest a wide range of patients, regardless of age and underlying disease. Trilinear cytopenias, as well as hypogammaglobulinemia, B-cell aplasia, and T-cell impairment, can severely affect the infectious risk of CAR-T recipients, as well as their quality of life. In this review, we provide an overview of defects in hematopoiesis after CAR-T, starting with a summary of different definitions and thresholds. We then move to summarize the main pathogenetic mechanisms of cytopenias, and we offer insight into cytomorphological aspects, the role of clonal hematopoiesis, and the risk of secondary myeloid malignancies. Subsequently, we expose the major findings and reports on T-cell and B-cell quantitative and functional impairment after CAR-T. Finally, we provide an overview of current recommendations and leading experiences regarding the management of cytopenias and defective B- and T-cell function.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reconstituição Imune
/
Receptores de Antígenos Quiméricos
Tipo de estudo:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Eur J Haematol
Ano de publicação:
2024
Tipo de documento:
Article