Abnormal bone marrow findings in patients following treatment with chimeric antigen receptor-T cell therapy.
Eur J Haematol
; 112(1): 111-121, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-37526606
ABSTRACT
BACKGROUND:
Bone marrow (BM) assessment after CAR-T cell immunotherapy infusion is not routinely performed to monitor adverse events such as cytopenias, hemophagocytic lymphohistiocytosis, or infections. Our institution has performed BM biopsies as part of CAR-T cell treatment protocols, encompassing pre- and post-treatment time points and during long-term follow-up.METHODS:
We conducted a systematic retrospective review of BM abnormalities observed in samples from 259 patients following CAR-T cell immunotherapy. We correlated BM pathology findings with mortality, relapse/residual disease, and laboratory values.RESULTS:
At a median of 35.5 days post-CAR-T infusion, 25.5% showed severe marrow hypocellularity, and 6.2% showed serous atrophy, and peripheral blood cytopenias corroborated these observations. Marrow features associated with reduced disease burden post-CAR-T infusion include increased lymphocytes seen in 16 patients and an increase of macrophages or granulomatous response seen in 25 patients. However, a 100-day landmark analysis also showed increased marrow histiocytes were associated with lower survival (median OS 6.0 vs. 21.4 months, p = .026), as was grade 2-3 marrow reticulin (18 patients) (median OS 12.5 vs. 24.2 months, p = .034).CONCLUSIONS:
These data represent the first systematic observations of BM changes in patients receiving CAR-T cell immunotherapy.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Receptores de Antígenos Quiméricos
/
Citopenia
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article