Table 2 Hematotoxicity and management
Characteristic | All Patients (n = 113) | CAR-HEMATOTOX Score | p | |
|---|---|---|---|---|
Low (n = 63) | High (n = 50) | |||
Severe thrombocytopenia (Platelet Count < 50 G/L) | ||||
Day 0–30 | 56 (49.6%) | 17 (27.0%) | 39 (78%) |  < 0.0001 |
Day 31–100 | 32 (28.3%) | 4 (6.3%) | 28 (56%) |  < 0.0001 |
Severe anemia (Hb < 8 g/dL or requiring transfusion) | ||||
Day 0–30 | 56 (49.6%) | 14 (22.2%) | 42 (84%) |  < 0.0001 |
Day 31–100 | 30 (26.5%) | 6 (9.5%) | 24 (48%) |  < 0.0001 |
Neutropenia | ||||
Phenotype of neutrophil recovery |  |  |  |  < 0.0001 |
  Quick | 45 (39.8%) | 39 (61.9%) | 6 (12%) |  |
  Intermittent | 50 (40.2%) | 22 (34.9%) | 28 (56%) |  |
  Aplastic | 18 (15.9%) | 2 (3.2%) | 16 (32%) |  |
Severe (ANC < 500/µL) | ||||
 Day 0–30 | 82 (72.6%) | 40 (63.5%) | 42 (84%) | 0.02 |
 Day 31–100 | 22 (19.5%) | 4 (6.3%) | 18 (36%) |  < 0.0001 |
Protracted, severe (ANC < 500/µL for ≥ 7 days) | 28 (24.8%) | 5 (7.9%) | 23 (46%) |  < 0.0001 |
Profound (ANC < 100/µL) Day 0–100 | 33 (29.2%) | 12 (19.0%) | 21 (42%) | 0.01 |
Protracted, profound (ANC < 100/µL for ≥ 7 days) | 7 (6.2%) | 0 (0%) | 7 (14%) | 0.003 |
Prolonged (ANC < 1000/µL measured ≥ 21 days after CAR-T) | 57 (50.4%) | 21 (33.3%) | 36 (72%) |  < 0.0001 |
Supportive therapies—n (%) | ||||
Platelet transfusion | ||||
 D1–30 | 33 (29.2%) | 4 (6.3%) | 29 (58%) |  < 0.0001 |
 D30–100 | 13 (11.5%) | 2 (3.2%) | 11 (22%) | 0.002 |
pRBC transfusion | ||||
 D1–30 | 52 (46.0%) | 13 (20.6%) | 39 (78%) |  < 0.0001 |
 D30–100 | 23 (20.4%) | 4 (6.3%) | 19 (38%) |  < 0.0001 |
Granulocyte colony stimulating factor (G-CSF) use | 59 (52.2%) | 28 (44.4%) | 31 (62%) | 0.087 |
 First day of G-CSF—median (range) | 9 (1–114) | 9 (3–30) | 9 (1–114) | 0.96 |
 Last day of G-CSF—median (range) | 22.5 (7–149) | 21 (7–149) | 27 (7–137) | 0.29 |
Thrombopoetin (TPO) agonist use | 10 (8.8%) | 3 (4.8%) | 7 (14%) | 0.01 |
 First day of TPO agonist—median (range) | 36 (4–125) | 41 (37–42) | 33 (4–125) | 0.38 |
 Last day of TPO agonist—median (range) | 42 (6–223) | 101 (37–140) | 42 (33–223) | 0.50 |
CD34 + Stem cell boost | 3 (2.7%) | N/A | 3 (6%) | 0.084 |
 Day of boost (range) | 84 (71–118) | N/A | 84 (71–118) |  |
 Dose of boost (CD34 + cells × 106/kg)—median (range) | 2.6 (2.41–2.97) | N/A | 2.6 (2.41–2.97) |  |
IVIG use | 24 (21.2%) | 16 (25.4%) | 8 (16%) |  > 0.9 |