ArticleBlood advances2021
Incidence and risk factors associated with bleeding and thrombosis following chimeric antigen receptor T-cell therapy.
Article in Blood advances, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Venous Thromboembolism Risk in Hematological Malignancies Post-Chimeric Antigen Receptor T-Cell (CAR-T) Therapy: A Meta-Analysis of Phase 2 and Phase 3 Clinical Trials.Current oncology (Toronto, Ont.) · 2024Pooled it
- A meta-analysis to assess the risk of bleeding and thrombosis following chimeric antigen receptor T-cell therapy: Communication from the ISTH SSC Subcommittee on Hemostasis and Malignancy.Journal of thrombosis and haemostasis : JTH · 2024Pooled it
- Phase 2 results of lisocabtagene maraleucel in Japanese patients with relapsed/refractory aggressive B-cell non-Hodgkin lymphoma.Cancer medicine · 2022Trial
- Guided immunotherapy for residual solid tumor: integrating platelets and CAR T cells to reduce post-surgical recurrence.Biomarker research · 2026Review
- Disseminated intravascular coagulation in chimeric antigen receptor T-cell therapy: a 6-year nationwide analysis of clinical outcomes and health care resource utilization in patients with hematologic malignancies.Research and practice in thrombosis and haemostasis · 2026Article
- Risk of thrombosis and bleeding following CAR T-cell therapy: Insights from the Dutch "Follow that CAR!" registry.HemaSphere · 2026Article
- Review
- Anticoagulation challenges in cancer patients: prevention, detection, and treatment strategies.Cardio-oncology (London, England) · 2026Review
- Redesigning CAR therapy to tackle immune effector cell-associated hematotoxicity.Annals of hematology · 2026Review
- Haemostatic changes during CART cell therapy and risk of complications.Cancer immunology, immunotherapy : CII · 2026Article
- Article
- Caught in the crossfire: cardiac complications of cancer therapy.The Journal of clinical investigation · 2026Review
- Cytopenias and infections following ciltacabtagene autoleucel in heavily pretreated relapsed or refractory multiple myeloma.Haematologica · 2026Article
- The future directions of CAR-T Cell therapy: unlocking the potential of immunotherapy in cancer treatment.Frontiers in molecular medicine · 2026Review
- Endotheliopathy in CAR T-Cell Therapy: Mechanistic Insights into the VWF/ADAMTS13 Axis and the Angiopoietin-Tie2 Pathway.TH open : companion journal to thrombosis and haemostasis · 2026Review
- Extramedullary disease is associated with severe toxicities following B-cell maturation antigen CAR T-cell therapy in multiple myeloma.Haematologica · 2025Article
- Article
- Venous Thromboembolic Events in Cancer Immunotherapy: A Narrative Review.Journal of clinical medicine · 2025Review
- Immunotherapy-associated hemostatic abnormalities: bleeding and thrombotic complications.Annals of hematology · 2025Review
- Noncanonical and mortality-defining toxicities of CAR T cell therapy.Nature medicine · 2025Review
Corrections and comments
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Authors and funding
21 authors at 1 institution in 1 country.
Funding
Abstract
Bleeding and thrombotic events are an emerging toxicity associated with chimeric antigen receptor (CAR) therapies. To determine their incidence, we retrospectively analyzed consecutive adult patients (N = 127) with large B-cell lymphoma (LBCL) or B-cell acute lymphoblastic leukemia (B-ALL) treated from 2017 through 2020 with axicabtagene ciloleucel (axi-cel; n = 89) or a bispecific CD19/CD22 CAR (n = 38). Twelve (9.4%) and 8 (6.3%) patients developed bleeding and thrombosis within the first 3 months, respectively. In the axi-cel subgroup, these occurred in 11.2% and 6.7%, respectively. Bleeding occurred between days 8 and 30 (median, 17.5) and thrombosis between days 2 and 91 (median, 29). Bleeding sites included genitourinary, soft tissue, intracranial, gastrointestinal, and pulmonary and were associated with features of consumptive coagulopathy. On univariate analysis, patients with bleeding were older, had lower baseline platelets (86 × 103/μL vs 178 × 103/μL; P < .01), lower platelet and fibrinogen nadirs , and elevated lactate dehydrogenase. Immune effector cell (IEC)-associated neurotoxicity syndrome (ICANS) grade ≥3 was associated with increased bleeding (50% vs 15%; P = .01), thrombosis (50% vs 16%; P = .04), prothrombin time prolongation, hypofibrinogenemia, and elevated D-dimer. Low pretreatment platelet counts were associated with bleeding in a multivariate logistic regression model. Patients with thrombocytopenia or severe ICANS are at increased risk of bleeding and should be closely monitored, particularly within the first month after CAR therapy. Future studies in larger cohorts should assess risk factors for systemic coagulopathies in CAR T therapy, including their association with neurotoxicity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.