Impact of late immune effector cell associated hematotoxicity (ICAHT) and prolonged neutropenia after CAR-T therapy on infection and survival outcomes.

• DOI: 10.1200/jco.2024.42.16_suppl.7041
• Publication Date: 2024-06-10T18:37:44Z
• Authors: Morgan Zenner; Spencer Lessans; Kai Rejeski; Miguel-Angel Perales; Richard T. Maziarz; Andy I. Chen; David L. Porter; Stephen J. Schuster; Joseph McGuirk; Michael Russell B...; Veronika Bachanova; Loretta J. Nastoupil; Peter A. Riedell; Olalekan O. Oluwole; Shakthi Bhaskar; Vivek Patel
• Keywords: 03 medical and health sciences; 0302 clinical medicine

7041 Background: Prolonged hematologic toxicity is a common side effect of chimeric antigen receptor T-cell (CART) therapy. The EHA/EBMT panel developed the late ICAHT grading which incorporates depth neutropenia after Day 30. Recently, early grade (D 0-30) was associated with infection (infx) and survival outcomes. Here, we evaluate impact on infx outcomes CD19 CART. Methods: We included two cohorts adult patients (pts) large B cell lymphoma (LBCL), mantle (MCL), follicular (FL) who received commercial Late graded based D30 (G1 ≤ 1.5; G2 1.0; G3 0.5; G4 0.1 G/L) pts were censored for relapse, progression, or loss follow up. Infxs per CTCAE as mild G 2 severe ≥ 3. Cohort 1 from 8 US medical centers Only data collected D30-D100 longer term not available. Landmark analysis at D+100 performed using Kaplan-Meier method multivariate cox proportional hazards. To assess long outcomes, cohort Vanderbilt granular cytopenia (D30-365). Results: 277 LBCL whom 143 axi-cel, 61 tisa-cel, 72 liso-cel median up 395 days (range 30-1763). By D100, there 111 (40%) without, 89 (41%) to moderate (G1-G2), 53 (19%) (G3-G4) ICAHT. There 13 (6%) (p=0.68). In landmark previously published covariates, PFS (HR 1.64, p=0.11) OS 1.54, p=0.17); however, D100 (ANC 1000) inferior 2.00, p=0.002) 1.95, p=0.003). NRM 11% (p=0.015) but (p=0.15). had 43 (35 LBCL, 7 MCL, FL) 483 233-2133). 34 brexu-cel. yr, 10 (23%) 27 (63%) moderate, 6 (14%) 52 infxs by yr 16 (37%) no infx. Median time first 165 31-365). 31 (60%) 21 IVIG used in 28 (65%) G-CSF (62%). pt logistic regression. Conclusions: These did show an association between survival. A detailed reporting T reconstitution may provide clues better predict Persistent needs validation future studies.