Capes Antoine, Morin Alexandra, Banet Anne, Suner Ludovic, Ricard Laure, Corre Elise, Brissot Eolia, Stocker Nicolas, Marjanovic Zora, Sarkozy Clémentine, Mohty Mohamad, Malard Florent
Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Paris, France.
Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.
Br J Haematol. 2025 Jan;206(1):180-185. doi: 10.1111/bjh.19822. Epub 2024 Oct 19.
Immune effector cell-associated hematotoxicity (ICAHT) is a common toxicity associated with an important morbidity after chimeric antigen receptor (CAR)-T-cell therapy. Multiple factors seem to be involved in the development of severe ICAHT, making its management difficult. Here, we report three cases of severe ICAHT after axicabtagene-ciloleucel (axi-cel) for diffuse large B-cell lymphoma showing an expansion of large granular lymphocyte in the bone marrow with a CD3/CD57-positive non-CAR-T immunophenotype. We show that it is possible to treat them with low-dose steroids, obtaining a striking resolution of cytopenias with no deleterious impact on the underlying malignancy.
免疫效应细胞相关血液毒性（ICAHT）是嵌合抗原受体（CAR）-T细胞治疗后常见的一种毒性，且常伴有严重发病情况。多种因素似乎都与严重ICAHT的发生有关，这使得其治疗颇具难度。在此，我们报告了3例接受阿基仑赛注射液（axi-cel）治疗弥漫性大B细胞淋巴瘤后发生严重ICAHT的病例，这些病例显示骨髓中存在大颗粒淋巴细胞扩增，其免疫表型为CD3/CD57阳性的非CAR-T细胞。我们发现，使用低剂量类固醇治疗这些患者是可行的，血细胞减少症得到了显著缓解，且对潜在恶性肿瘤没有不良影响。
