ArticleBlood advances2023
HLH-like toxicities predict poor survival after the use of tisagenlecleucel in children and young adults with B-ALL.
Article in Blood advances, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 23 citations in OpenAlex.
- HLH-like syndromes associate with increased risk of death and CD19- relapse after CAR T in pediatric B-ALL.Blood advances · 2026Observational
- CAR T-cell therapy as a definitive consolidation for older adults with B-ALL in first complete remission.Blood advances · 2026Article
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- The evolving landscape of CAR T cell therapy in children and young adults with B cell acute lymphoblastic leukemia.Molecular therapy. Oncology · 2026Review
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- Chimeric antigen receptor T-cell therapies related to immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome: Diagnosis, high-risk factors, and management.Chinese medical journal · 2026Review
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- Ten-year experience of CD22 CAR T cells for children and young adults with B-cell acute lymphoblastic leukemia.Blood advances · 2026Article
- Management Practices of CAR T-cell-Related Inflammatory Toxicities: A Survey of Pediatric CAR T-cell Providers.Transplantation and cellular therapy · 2026Article
- Liberalizing hospital proximity requirements for children/young adults with low-burden B-ALL receiving tisagenlecleucel.Blood advances · 2026Article
- Case Report: refractory hemophagocytic lymphohistiocytosis progression despite complete metabolic response in a patient with stage IV extranodal NK/T-cell lymphoma: clinical observation of "tumor-immune dissociation" phenomenon.Frontiers in immunology · 2026Article
- Characterization and prediction of prolonged severe neutropenia in pediatric patients receiving tisagenlecleucel.Blood advances · 2025Article
- Low Peripheral Blood Counts and Elevated Proinflammatory Cytokines Signal a Poor CD19 Chimeric Antigen Receptor T-cell Response in Acute Lymphoblastic Leukemia.Transplantation and cellular therapy · 2025Article
- Less frequent complications following CAR T-cell therapies: hemophagocytic lymphohistiocytosis, graft-versus-host disease, thrombotic microangiopathy, coagulation disorders and secondary malignancies: best practice recommendations from the EBMT Practice Harmonization and Guidelines Committee.Bone marrow transplantation · 2025Review
- Immune Effector Cell-associated Hemophagocytic Lymphohistiocytosis-like Syndrome (IEC-HS).Hematology/oncology clinics of North America · 2025Review
- Treating and triggering hyperinflammation: tackling hemophagocytic lymphohistiocytosis and HLH-like syndromes in the pediatric cell therapy and critical care setting.Frontiers in oncology · 2025Review
- Evolving strategies for addressing CAR T-cell toxicities.Cancer metastasis reviews · 2024Review
- Mitigating and managing infection risk in adults treated with CAR T-cell therapy.Hematology. American Society of Hematology. Education Program · 2024Review
- Treatment strategies for progressive immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome: case seriesHaematologica · 2024Article
- Overcoming the challenges of primary resistance and relapse after CAR-T cell therapy.Expert review of clinical immunology · 2024Review
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Authors and funding
33 authors at 20 institutions in 1 country.
Funding
Abstract
Chimeric antigen receptor-associated hemophagocytic lymphohistiocytosis (HLH)-like toxicities (LTs) involving hyperferritinemia, multiorgan dysfunction, coagulopathy, and/or hemophagocytosis are described as occurring in a subset of patients with cytokine release syndrome (CRS). Case series report poor outcomes for those with B-cell acute lymphoblastic leukemia (B-ALL) who develop HLH-LTs, although larger outcomes analyses of children and young adults (CAYAs) with B-ALL who develop these toxicities after the administration of commercially available tisagenlecleucel are not described. Using a multi-institutional database of 185 CAYAs with B-ALL, we conducted a retrospective cohort study including groups that developed HLH-LTs, high-grade (HG) CRS without HLH-LTs, or no to low-grade (NLG) CRS without HLH-LTs. Primary objectives included characterizing the incidence, outcomes, and preinfusion factors associated with HLH-LTs. Among 185 CAYAs infused with tisagenlecleucel, 26 (14.1%) met the criteria for HLH-LTs. One-year overall survival and relapse-free survival were 25.7% and 4.7%, respectively, in those with HLH-LTs compared with 80.1% and 57.6%, respectively, in those without. In multivariable analysis for death, meeting criteria for HLH-LTs carried a hazard ratio of 4.61 (95% confidence interval, 2.41-8.83), controlling for disease burden, age, and sex. Patients who developed HLH-LTs had higher pretisagenlecleucel disease burden, ferritin, and C-reactive protein levels and lower platelet and absolute neutrophil counts than patients with HG- or NLG-CRS without HLH-LTs. Overall, CAYAs with B-ALL who developed HLH-LTs after tisagenlecleucel experienced high rates of relapse and nonrelapse mortality, indicating the urgent need for further investigations into prevention and optimal management of patients who develop HLH-LTs after tisagenlecleucel.
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