Toxicity from CAR-T according to bridging strategy
| . | No bridging . | Bridging therapy . | P-value . | |||
|---|---|---|---|---|---|---|
| Steroids . | RT . | CT . | CMT . | |||
| N = 40 . | N = 29 . | N = 54 . | N = 166 . | N = 11 . | ||
| CAR-T toxicities | ||||||
| CRS (grade 3+), N (%) | 1 (2.5) | 4 (13.8) | 5 (9.3) | 11 (6.6) | 2 (18.2) | .19 |
| ICANS (grade 3+), N (%) | 7 (17.5) | 6 (20.7) | 8 (14.8) | 26 (15.7) | 0 | .64 |
| Grade 3+ Neutropenia (1 mo)∗ | 9/33 (27.3) | 9/20 (45.0) | 20/45 (44.4) | 64/114 (44.4) | 4/10 (40.0) | .051 |
| Grade 3+ Neutropenia (3 mo)∗ | 3/20 (15.0) | 2/8 (25.0) | 7/31 (22.6) | 13/67 (19.4) | 1/5 (20.0) | .94 |
| Grade 3+ Thrombocytopenia (1 mo)∗ | 7/34 (20.6) | 6/30 (30.0) | 15/47 (31.9) | 65/116 (56.0) | 1/10 (10.0) | <.001 |
| Grade 3+ Thrombocytopenia (3 mo)∗ | 1/20 (5.0) | 0/8 (0) | 2/31 (6.5) | 15/67 (22.4) | 1/5 (20) | .11 |
| Toxicity therapies | ||||||
| Steroids given, N (%) | 15 (37.5) | 13 (44.8) | 23 (45.6) | 61 (36.8) | 4 (36.4) | .88 |
| Tocilizumab used, N (%) | 22 (55.0) | 30 (69.0) | 39 (72.2) | 114 (68.7) | 5 (45.5) | .22 |
| ITU required, N (%) | 9 (22.5) | 11 (37.9) | 14 (25.9) | 46 (27.7) | 3 (27.3) | .72 |
| Observation only | 1 (2.5) | 3 (10.3) | 6 (11.1) | 15 (9.1) | 0 | |
| Inotropes | 4 (10.0) | 5 (17.2) | 5 (9.3) | 16 (9.7) | 3 (26.3) | |
| Organ support/Intubation | 4 (10.0) | 3 (10.3) | 3 (5.6) | 14 (8.5) | 0 | |
| Cumulative incidence of NRM at 1 y | 8.0% (2.6-23.0) | 3.5% (0.5-22.1) | 3.7% (0.9-14.0) | 9.4% (5.6-15.5) | 0% | |
| NRM events | 3 | 1 | 2 | 15 | 0 | |
| Infection† | 2 | 1 | 1 | 11 | 0 | |
| Cardiac | 1 | 0 | 0 | 0 | 0 | |
| Haematemesis | 0 | 0 | 1 | 0 | 0 | |
| Second malignancy | 0 | 0 | 0 | 1 | 0 | |
| HLH | 0 | 0 | 0 | 1 | 0 | |
| Bowel perforation | 0 | 0 | 0 | 2 | 0 | |
| . | No bridging . | Bridging therapy . | P-value . | |||
|---|---|---|---|---|---|---|
| Steroids . | RT . | CT . | CMT . | |||
| N = 40 . | N = 29 . | N = 54 . | N = 166 . | N = 11 . | ||
| CAR-T toxicities | ||||||
| CRS (grade 3+), N (%) | 1 (2.5) | 4 (13.8) | 5 (9.3) | 11 (6.6) | 2 (18.2) | .19 |
| ICANS (grade 3+), N (%) | 7 (17.5) | 6 (20.7) | 8 (14.8) | 26 (15.7) | 0 | .64 |
| Grade 3+ Neutropenia (1 mo)∗ | 9/33 (27.3) | 9/20 (45.0) | 20/45 (44.4) | 64/114 (44.4) | 4/10 (40.0) | .051 |
| Grade 3+ Neutropenia (3 mo)∗ | 3/20 (15.0) | 2/8 (25.0) | 7/31 (22.6) | 13/67 (19.4) | 1/5 (20.0) | .94 |
| Grade 3+ Thrombocytopenia (1 mo)∗ | 7/34 (20.6) | 6/30 (30.0) | 15/47 (31.9) | 65/116 (56.0) | 1/10 (10.0) | <.001 |
| Grade 3+ Thrombocytopenia (3 mo)∗ | 1/20 (5.0) | 0/8 (0) | 2/31 (6.5) | 15/67 (22.4) | 1/5 (20) | .11 |
| Toxicity therapies | ||||||
| Steroids given, N (%) | 15 (37.5) | 13 (44.8) | 23 (45.6) | 61 (36.8) | 4 (36.4) | .88 |
| Tocilizumab used, N (%) | 22 (55.0) | 30 (69.0) | 39 (72.2) | 114 (68.7) | 5 (45.5) | .22 |
| ITU required, N (%) | 9 (22.5) | 11 (37.9) | 14 (25.9) | 46 (27.7) | 3 (27.3) | .72 |
| Observation only | 1 (2.5) | 3 (10.3) | 6 (11.1) | 15 (9.1) | 0 | |
| Inotropes | 4 (10.0) | 5 (17.2) | 5 (9.3) | 16 (9.7) | 3 (26.3) | |
| Organ support/Intubation | 4 (10.0) | 3 (10.3) | 3 (5.6) | 14 (8.5) | 0 | |
| Cumulative incidence of NRM at 1 y | 8.0% (2.6-23.0) | 3.5% (0.5-22.1) | 3.7% (0.9-14.0) | 9.4% (5.6-15.5) | 0% | |
| NRM events | 3 | 1 | 2 | 15 | 0 | |
| Infection† | 2 | 1 | 1 | 11 | 0 | |
| Cardiac | 1 | 0 | 0 | 0 | 0 | |
| Haematemesis | 0 | 0 | 1 | 0 | 0 | |
| Second malignancy | 0 | 0 | 0 | 1 | 0 | |
| HLH | 0 | 0 | 0 | 1 | 0 | |
| Bowel perforation | 0 | 0 | 0 | 2 | 0 | |
Patients with PD are excluded, †Infection details: None; Covid-19, steroids; RSV pneumonia, RT; Sepsis (NOS), Systemic; Covid-19 (N = 5), Fungal chest infection/HLH (N = 1), Necrotizing fasciitis (N = 1), sepsis (NOS) (N = 3), fungal sepsis (N =1) Notes: 1 ITU level missing (CT bridging).