Clinical course after dual CAR T-cell therapy. (A) Timeline of treatment and CAR T-cell therapy–related adverse events and management. (B) Laboratory parameters supporting the diagnosis of IEC-HS. (C) Time-course analysis of inflammatory markers, sIL2R and ferritin, in the PB. (D) Time-course analysis of LDH and fibrinogen in the PB. (E) Time-course analysis of treatment-related hematotoxicity affecting neutrophil and platelet counts. (F) Time-course analysis of CAR T-cell expansion in the PB. (G-H) Flow cytometry–based phenotyping of CAR T cells in the PB for CD19/22 CAR T cells (G) and BCMA CAR T cells at early and late time points (H). (I) Time-course analysis of BM blasts and plasma cells, as well as ALL-MRD levels (low positive indicates MRD positive below quantifiable threshold). (J) Time-course analysis of MM paraprotein levels. (K) Imaging studies of right clavicle MM lesion with paramedullary involvement on admission (CT scan, upper) and ∼7 months after CAR T-cell therapy (MR imaging, lower). ANC, absolute neutrophil count; CRS, cytokine release syndrome; CT, computed tomography; G-CSF, granulocyte-macrophage colony-stimulating factor; GPT, glutamate-pyruvate transaminase; γ-GT; gamma-glutamyl transferase; ICAHT, immune effector cell–associated hematotoxicity; ICANS, immune effector cell-associated neurotoxicity syndrome; IEC-HS, immune effector cell–associated hemophagocytic lymphohistiocytosis–like syndrome; IgG, immunoglobulin G; LC, light chain; LD, lymphodepletion; LDH, lactate dehydrogenase; MR, magnetic resonance; PE-Cy7, phycoerythrin-cyanine7; PLT, platelets; sIL-2R, soluble interleukin-2 receptor; TCM, central memory T cells; TEM, effector memory T cells; TEMRA, effector memory CD45RA T cells; TN, naïve T cells.

Clinical course after dual CAR T-cell therapy. (A) Timeline of treatment and CAR T-cell therapy–related adverse events and management. (B) Laboratory parameters supporting the diagnosis of IEC-HS. (C) Time-course analysis of inflammatory markers, sIL2R and ferritin, in the PB. (D) Time-course analysis of LDH and fibrinogen in the PB. (E) Time-course analysis of treatment-related hematotoxicity affecting neutrophil and platelet counts. (F) Time-course analysis of CAR T-cell expansion in the PB. (G-H) Flow cytometry–based phenotyping of CAR T cells in the PB for CD19/22 CAR T cells (G) and BCMA CAR T cells at early and late time points (H). (I) Time-course analysis of BM blasts and plasma cells, as well as ALL-MRD levels (low positive indicates MRD positive below quantifiable threshold). (J) Time-course analysis of MM paraprotein levels. (K) Imaging studies of right clavicle MM lesion with paramedullary involvement on admission (CT scan, upper) and ∼7 months after CAR T-cell therapy (MR imaging, lower). ANC, absolute neutrophil count; CRS, cytokine release syndrome; CT, computed tomography; G-CSF, granulocyte-macrophage colony-stimulating factor; GPT, glutamate-pyruvate transaminase; γ-GT; gamma-glutamyl transferase; ICAHT, immune effector cell–associated hematotoxicity; ICANS, immune effector cell-associated neurotoxicity syndrome; IEC-HS, immune effector cell–associated hemophagocytic lymphohistiocytosis–like syndrome; IgG, immunoglobulin G; LC, light chain; LD, lymphodepletion; LDH, lactate dehydrogenase; MR, magnetic resonance; PE-Cy7, phycoerythrin-cyanine7; PLT, platelets; sIL-2R, soluble interleukin-2 receptor; TCM, central memory T cells; TEM, effector memory T cells; TEMRA, effector memory CD45RA T cells; TN, naïve T cells.

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