Scholarlink

<p>Chimeric antigen receptor T cell (CART) therapy toxicity includes cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), but also thrombotic and haemorrhagic events. Given the link between haemostasis and inflammation, haemostatic biomarkers could help identify at-risk patients. Sixty-two adult patients receiving CD19- or BCMA-targeted CART were prospectively included and followed up for 30 days to characterize haemostatic changes and evaluate their association with the risk of CRS, ICANS, thrombosis and bleeding. Blood samples were collected at baseline (pre-lymphodepletion), pre-infusion and on days + 3, + 14, and + 28 post-infusion. Haemostatic tests, including thrombin generation assay (TGA, ST-Genesia) and P-Selectin, were performed. CRS occurred in 94% of patients, ICANS in 39%, venous thrombosis in 1.6%, and clinically relevant bleeding in 13%. During follow-up, prolonged coagulation times, thrombocytopenia and decreased fibrinogen and P-selectin, were noted. Baseline endogenous thrombin potential (ETP) was associated with clinically relevant CRS risk (OR 12.39; <i>p</i> = 0.02) and baseline C-reactive protein (CRP) with ICANS (OR 1.66; <i>p</i> &lt; 0.01). Baseline P-selectin levels and platelet count identified patients at higher bleeding risk (OR 0.20; <i>p</i> = 0.03 and OR 0.39; <i>p</i> &lt; 0.01, respectively). In the first month after CART infusion, bleeding incidence exceeds thrombosis. TGA, CRP, platelet count and P-selectin may help identify patients at risk of severe toxicity, enabling earlier, targeted interventions.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Haemostatic changes during CART cell therapy and risk of complications

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月31日

查看全文
  • María Panizo-Inogés,
  • María Marcos-Jubilar,
  • Jose Ramón González-Porras,
  • Carlos Puerta-Vazquez,
  • Clara Fernández-Arias,
  • Paula Rodríguez-Otero,
  • Ana Alfonso-Pierola,
  • Sara Villar,
  • Miguel Ángel Canales,
  • Josune Orbe,
  • Jose Antonio Páramo,
  • Felipe Prósper,
  • Ramón Lecumberri

摘要

Chimeric antigen receptor T cell (CART) therapy toxicity includes cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), but also thrombotic and haemorrhagic events. Given the link between haemostasis and inflammation, haemostatic biomarkers could help identify at-risk patients. Sixty-two adult patients receiving CD19- or BCMA-targeted CART were prospectively included and followed up for 30 days to characterize haemostatic changes and evaluate their association with the risk of CRS, ICANS, thrombosis and bleeding. Blood samples were collected at baseline (pre-lymphodepletion), pre-infusion and on days + 3, + 14, and + 28 post-infusion. Haemostatic tests, including thrombin generation assay (TGA, ST-Genesia) and P-Selectin, were performed. CRS occurred in 94% of patients, ICANS in 39%, venous thrombosis in 1.6%, and clinically relevant bleeding in 13%. During follow-up, prolonged coagulation times, thrombocytopenia and decreased fibrinogen and P-selectin, were noted. Baseline endogenous thrombin potential (ETP) was associated with clinically relevant CRS risk (OR 12.39; p = 0.02) and baseline C-reactive protein (CRP) with ICANS (OR 1.66; p < 0.01). Baseline P-selectin levels and platelet count identified patients at higher bleeding risk (OR 0.20; p = 0.03 and OR 0.39; p < 0.01, respectively). In the first month after CART infusion, bleeding incidence exceeds thrombosis. TGA, CRP, platelet count and P-selectin may help identify patients at risk of severe toxicity, enabling earlier, targeted interventions.