Late Lymphocytopenia, Neutropenia, and Thrombocytopenia Following Axicabtagene Ciloleucel and Tisagenlecleucel CAR-T Cell Therapy: A Retrospective Study

This study aimed to provide a 2024 update on cumulative survival (CS) and the incidence of lymphocytopenia, neutropenia, and thrombocytopenia, following axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) CAR-T cell therapies. It reviewed 56 consecutive patients who received adoptive CAR-T cell therapy for diffuse large B cell lymphoma, from 2019 to March 2024. Group A included 34 patients treated with axi-cel (Yescarta®), and Group B included 22 patients treated with tisa-cel (Kymriah®). It was estimated the cumulative survival (CS), by the Kaplan-Meyer method, and the occurrence of late cytopenias beyond day 60 (“late”), according to the most recent blood samples collected following the established protocol, the grading is done based on the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events.

The cohort (n=56) was composed of 49% female, 55 (9) years old, weight of 75 (23) kg, and height of 161(18) cm. 50.7% patients on axi-cel (Group A), and 32.8% on tisa-cel (Group B). The CS for axi-cel treated 65.5% and for 56.5% for tisa-cel and toxicity showed that overall lymphopenia, neutropenia, and thrombocytopenia were 21.4%, 5.3%, and 12.5%, respectively. The average disease-free period until the end of data collection (March 2024) was 19 (14) months, and the average time to death from any cause was 10 (9) months. The findings from our study suggest that the development of late cytopenia after CAR T-cell therapy is uncommon and may occur through various mechanisms in susceptible patients.

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