SynthesisAnnals of medicine2022
Cytopenias following anti-CD19 chimeric antigen receptor (CAR) T cell therapy: a systematic analysis for contributing factors.
Synthesis in Annals of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Efficacy and safety of chimeric antigen receptor T-cell in the treatment of hematologic malignancy: an umbrella review of systematic review and meta-analysis.Frontiers in immunology · 2025Pooled it
- Immune effector cell-associated hematotoxicity following CAR-T cell therapies: insights from a large national database.Japanese journal of clinical oncology · 2026Article
- Late phase transfusion after CAR T therapy is associated with persistent hematotoxicity and non-relapse mortality in multiple myeloma: a post hoc analysis.BMC medicine · 2026Article
- Targeting T-Cells for Cancer Treatment: Current Clinical Strategies and Challenges.Biomedicines · 2026Review
- Spectrum and prognosis of CAR-T-related endocrine toxicity: glucose/calcium dysregulation, pituitary axis disorders, and overlap with CRS.Frontiers in medicine · 2026Article
- Infections and CAR-T cells for the treatment of lymphoid malignancies: a narrative review.Frontiers in medicine · 2026Review
- Sex-related differences in the efficacy and toxicity of cancer treatments.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Bridging intensity is associated with impaired hematopoietic recovery after BCMA CAR-T therapy for multiple myeloma.Blood advances · 2025Observational
- Observational
- Mitigation and Management of Common Toxicities Associated with the Administration of CAR-T Therapies in Oncology Patients.Drug safety · 2025Review
- CAR-T cell therapy in older adults with relapsed/refractory LBCL: benefits and challenges.Journal for immunotherapy of cancer · 2025Review
- Immune effector cell-associated hematotoxicity: mechanisms, clinical manifestations, and management strategies.Haematologica · 2025Review
- Article
- Development and validation of predictive models of early immune effector cell-associated hematotoxicity.Blood advances · 2025Article
- Clinical outcomes of chimeric antigen receptor T-cell therapy following autologous hematopoietic stem cell transplantation in 38 patients with refractory/relapsed primary or secondary central nervous system lymphoma.Cancer immunology, immunotherapy : CII · 2024Article
- New insights into CAR T-cell hematological toxicities: manifestations, mechanisms, and effective management strategies.Experimental hematology & oncology · 2024Review
- Review
- Mesenchymal stem cell infusion for enhancing hematopoietic recovery and addressing cytopenias in CAR-T cell therapy.Stem cell research & therapy · 2024Article
- Prolonged cytopenias after immune effector cell therapy and lymphodepletion in patients with leukemia, lymphoma and solid tumors.Cytotherapy · 2024Article
- Immune effector cell-associated haematotoxicity after CAR T-cell therapy: from mechanism to management.The Lancet. Haematology · 2024Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCytopenia is one of the most common adverse events following the CAR-T cell infusion, affecting the quality of life and potentially leading to life-threatening bleeding and infection. This study aimed to systematically review the cytopenias following anti-CD19 CAR-T therapy and further analyse the contributing factors.
methodsDatabases including PubMed, MEDLINE, Embase and Cochrane were systematically searched on 8 May 2022. A random-effect meta-analysis was used to estimate the incidence of cytopenia, and subgroup analyses were applied to explore heterogeneity.
resultsA total of 68 studies involving 2950 patients were included in this study. The overall incidence of all grade anaemia, thrombocytopenia, neutropenia, leukopoenia, lymphocytopenia and febrile neutropenia was 65%, 55%, 78%, 62%, 70% and 27%, respectively, and the corresponding cytopenias of grade 3 or worse were 33%, 31%, 61%, 45%, 46%, and 21%, respectively. Subgroup analysis showed increased incidence of cytopenias in subgroups with lower median age, proportion of males (<65%) and proportion of bridging therapy (<80%) and in the subgroup with a median line of prior therapy ≥3. In terms of disease and therapeutic target, cytopenias were more frequent in ALL patients and in dual-target CAR-T therapies (targeting CD19 in combination with other targets). Furthermore, CAR-T products manufactured by lentiviral vectors and those with the costimulatory domain of CD28 were more likely to cause haematological toxicity. No significant differences were observed in cytopenia between patients treated with CAR-T products with murine and humanized scFv.
conclusionIn conclusion, neutropenia is the most frequent cytopenia after CAR-T therapy, both in all grades or grade ≥3. The incidence of cytopenias following CAR-T therapy is influenced by the age, sex, disease and number of prior therapy lines of the patients, as well as the target and costimulatory domain of CAR-T cells, and viral vectors used for manufacturing.KEY MESSAGESNeutropenia is the most frequent cytopenia after CAR-T therapy.The clinical characteristics of the patients, the design of CAR-T cells and the protocol of CAR-T treatment can influence the occurrence of cytopenias following the CAR-T therapy.
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