What causes cytopenias in patients undergoing chimeric antigen receptor (CAR) T-cell therapy?

Updated: Dec 17, 2020
  • Author: Sameh Gaballa, MD, MS; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Low blood counts, including neutropenia and thrombocytopenia, are common after CAR T therapy and can last from weeks to several months. Prolonged neutropenia can place patients at increased risk of infection. The etiology of cytopenias post–CAR T therapy is poorly understood, and while early cytopenias can be attributed to lymphodepleting therapy, prolonged cytopenias can occur in patients who have not received lymphodepleting chemotherapy. [43]  Interestingly, a prolonged CD4 T cell deficit has been described. [44, 45]  While the optimal strategy is not known, many centers provide re-vaccination and prophylaxis against Pneumocystis jirovecii pneumonia and varicella-zoster virus infection.

 


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