ObjectiveThis research explores the clinical features and prognosis of prolonged cytopenia (PC) in diffuse large B-cell lymphoma (DLBCL) patients undergoing anti-CD19 CAR-T cell therapy. MethodsA retrospective study was conducted on DLBCL patients who received CAR-T cell therapy and had a minimum one-month follow-up at Peking Union Medical College Hospital's Hematology Department from March 2019 to December 2023. Patients were categorized into PC and non-PC groups based on cytopenia occurrence at 90 days post-infusion. ResultsThe study involved 27 patients, median age 58 years, including 18 males (66.7%). PC occurred in 19 patients (70.4%), including neutropenia (48.1%), anemia (37.0%), and thrombocytopenia (22.2%). In the PC group, there was higher chemotherapy sensitivity (95% vs 50%, P=0.006), lower cytokine release syndrome incidence (64% vs 100%, P=0.046), and lower baseline neutrophil levels (2.59±0.96 vs 4.20±1.93, P=0.007) compared to the non-PC group. Prior chemotherapy sensitivity was associated with PC (OR 18, 95% CI 1.56-207.45, P=0.02). The PC group had a lower overall response rate (80.0% vs 87.5%), increased infection risk (47.4% vs 12.5%), and shorter progression-free survival (19.3 vs 24.4 months), but these differences were not statistically significant (P>0.05). Conclusions PC is common post CAR-T cell therapy, associated with higher infection risk and poorer prognosis. Prior treatment sensitivity and lower neutrophil levels may be PC indicators.

Disclosures

No relevant conflicts of interest to declare.

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2024
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