Year: 2025
Type: article
Study design: Observational Study
Abstract: Hematotoxicity after anti‐CD19 chimeric antigen receptor T‐cell therapy has drawn attention for potential long‐term effects, and yet, recovery of lymphocyte subsets and immunoglobulin levels beyond B‐cell aplasia remains poorly understood. We retrospectively analyzed 76 consecutive axicabtagene ciloleucel (axi‐cel) recipients with relapsed/refractory aggressive B‐cell lymphoma between 2020 and 2024, focusing on basic immune recovery patterns and their impact on outcomes. Median CD8 + T and NK cells increased to >300/mm 3 and >100/mm 3 , respectively, within 2 months after infusion. CD4 + T‐cell recovery was slower, with 42% cumulative incidence of >200/mm 3 cell count at 12 months. B‐cells were detectable in 18% at 12 months. Immunoglobulin levels initially declined and then plateaued, with 51% incidence of immunoglobulin G (IgG) levels > 400 mg/dL at 12 months. Modified EASIX > 2.00 was associated with delayed kinetics of CD3 + T‐cells, CD4 + T‐cells, and CD8 + T‐cells, and cumulative dexamethasone dose > 120 mg with delayed recovery of CD4 + T‐cells, NK cells, and IgG. At 1 month post‐infusion, low CD4 + T‐cell count and high CAR‐HEMATOTOX predicted worse 12‐month progression‐free survival (hazard ratio [HR] 2.81 and 3.34) and overall survival (HR 3.21 and 4.41), respectively. After axi‐cel, CD4 + T‐cells and IgG recovered slowly during the first year, while CD8 + T and NK cells increased rapidly. A higher modified EASIX score may predict slower cellular recovery, while corticosteroids may delay both cellular and humoral recovery. Lower CD4 + T‐cell count was associated with worse outcomes.
Source: HemaSphere
DOI: 10.1002/hem3.70229
Authors: André Airosa Pardal, Ana Benzaquén, Pablo Granados, Paula Amat, Rafael Hernani, Aitana Balaguer‐Roselló, Ariadna Pérez, Marta Villalba, Pedro Asensi, Blanca Ferrer, Lourdes Cordón, Irene Pastor‐Galán, Juan Montoro, María José Remigia, Juan Carlos Hernández‐Boluda, Amparo Sempere, Jaime Sanz, María José Terol, Carlos Solano, Pedro Chorão, José Luis Piñana
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,480
OpenAlex ID: W4414835429