Effect of early granulocyte-colony-stimulating factor administration in the prevention of febrile neutropenia and impact on toxicity and efficacy of anti-CD19 CAR-T in patients with relapsed/refractory B-cell lymphoma

Raphaël Liévin, Roberta Di Blasi, Florence Morin, Eugenio Galli, Vincent Allain, Romain De Jorna, Laetitia Vercellino, Nathalie Parquet, Miryam Mebarki, Jerome Larghero, Eric De Kerviler, Isabelle Madelaine, Sophie Caillat-Zucman, Sylvie Chevret, Catherine Thieblemont

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Chimeric Antigen Receptor T cells (CAR-T) are an outbreaking treatment option for relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are the most common specific toxicities, while severe neutropenia and infections are often observed as well. From March 2020, early G-CSF prophylaxis at day (D) two post-infusion was systematically proposed. We then compared patients treated before that date who did not receive G-CSF or who received late (after D5) G-CSF as control group. Patients administered with early G-CSF had similar duration of grade 4 neutropenia but significantly decreased incidence of febrile neutropenia (58% versus 81%, p = 0.018). Similar rate of toxicities was observed, including overall and grade 3-4 CRS (p = 0.93 and p = 0.28, respectively), and overall and grade 3-4 ICANS (p = 0.62 and p = 0.88, respectively). We observed no difference in the quality of CAR T-cells expansion (p = 0.79, %Cmax), nor in response rate (best ORR, 57.6% vs 61.8%, p = 0.93), nor survival even in a group of patients adjusted by a propensity score. In conclusion, early G-CSF administration was safe and effective in reducing febrile neutropenia without impact on toxicities nor on anti-lymphoma activity of CAR-T.
Lingua originaleEnglish
pagine (da-a)431-439
Numero di pagine9
RivistaBone Marrow Transplantation
Volume57
DOI
Stato di pubblicazionePubblicato - 2022
Pubblicato esternamente

Keywords

  • CAR-T
  • Cytopenia
  • Granulocyte Colony Stimulating Factor

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