Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Leuk Lymphoma. 2022 Jun;63(6):1363-1368. doi: 10.1080/10428194.2022.2030475. Epub 2022 Feb 3.
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.
嵌合抗原受体 (CAR) T 细胞疗法在复发/难治性大 B 细胞淋巴瘤中有效，并且会产生独特的毒性特征，即细胞因子释放综合征 (CRS) 和免疫效应细胞相关神经毒性综合征。这些毒性相关的过度炎症状态被认为会增加血栓形成的风险。我们对接受 axicabtagene ciloleucel（axi-cel）治疗的患者进行了回顾性分析，以评估从 CAR T 细胞输注开始到住院结束时（在住院环境中进行）或门诊环境中进行时最多到第 30 天时，axi-cel 治疗的血栓形成率。97 例患者中有 92 例（95%）在 axi-cel 治疗期间住院，85 例（88%）发生了 CRS。55 例（57%）患者接受了同时抗凝治疗（53 例作为预防）。有 VTE 既往史的患者没有进展或新 VTE 的证据。只有 2 例（2.1%）患者发生了 VTE。这些结果表明 axi-cel 受者的血栓形成风险较低。
