Titre :

An International Survey on Grading, Diagnosis, and Management of Immune Effector Cell-Associated Hematotoxicity (ICAHT) Following CAR T-cell Therapy on Behalf of the EBMT and EHA.

Auteur(s) :

Rejeski, Kai [Auteur]
Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München [LMU]
Greco, Raffaella [Auteur]
San Raffaele Scientific Institute
Onida, Francesco [Auteur]
Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
Sánchez-Ortega, Isabel [Auteur]
Bonini, Chiara [Auteur]
IRCCS San Raffaele Scientific Institute [Milan, Italie]
Sureda, Anna [Auteur]
Universitat de Barcelona [UB]
Gribben, John G. [Auteur]
Queen Mary University of London [QMUL]
Yakoub-Agha, Ibrahim [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Subklewe, Marion [Auteur]
Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München [LMU]

Titre de la revue :

HemaSphere

Nom court de la revue :

HEMASPHERE

Numéro :

7

Pagination :

e889

Date de publication :

2023-05-02

ISSN :

2572-9241

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Hematological toxicity represents the most common grade ≥3 toxicity after chimeric antigen receptor (CAR) T-cell therapy. However, its underlying pathophysiology is incompletely understood and its grading and management ...
Lire la suite >Hematological toxicity represents the most common grade ≥3 toxicity after chimeric antigen receptor (CAR) T-cell therapy. However, its underlying pathophysiology is incompletely understood and its grading and management remains ill-defined. To inform the forthcoming European Hematology Association/European Society for Blood and Marrow Transplantation (EHA/EBMT) guidelines on the management of “immune effector cell-associated hematotoxicity” (ICAHT), we undertook a survey of experienced clinicians using an online survey focusing on (1) grading, (2) risk-stratification and diagnostic work-up, (3) short-term, and (4) long-term management of ICAHT. There were 81 survey respondents across 18 countries. A high degree of variability was noted for cytopenia grading in regards to depth, duration, and time from CAR-T infusion. The majority of experts favored pre-CAR-T bone marrow studies, especially in case of a high-risk profile. Most respondents felt that the work-up for patients with severe hematotoxicity should rule-out viral infections (96%), substrate deficiency (80%), or coincident sHLH/MAS (serum ferritin, 92%), and should include bone marrow aspiration (86%) and/or biopsy (61%). Clinicians were divided as to whether the occurrence of coincident immunotoxicity should influence the decision to apply G-CSF, and when to initiate G-CSF support. In case of prolonged thrombocytopenia, most survey participants favored thrombopoietin agonists (86%). Conversely, autologous hematopoietic cell boosts represented the preferred choice for neutropenia (63%), although they were frequently not available and no consensus was reached regarding the optimal trigger point. These findings underline the current heterogeneity of practice patterns regarding ICAHT and invite the development of consensus guidelines, which may harmonize grading, establish standard operating procedures for diagnosis, and set management guidelines.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Date de dépôt :

2024-01-11T22:52:40Z
2024-03-22T14:52:59Z