Incidence of post CAR-T cytopenias in clinical trials
| Trial/product . | Disease . | Target/endodomain/vector . | Lymphodepletion . | Grade ≥3 neutropenia, % . | Grade ≥3 thrombocytopenia, % . | Grade ≥3 anemia, % . | Reference . |
|---|---|---|---|---|---|---|---|
| ZUMA-3 Brexu-cel | BCP-ALL | CD19/CD28z/RV | Flu 25 mg/m2 × 3 Cy 900 mg/m2 × 1 | 27% | 30% | 49% | Shah et al. Lancet 20213 |
| ZUMA-1 Axi-cel | LBCL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 78% | 38% | 43% | Locke et al. Lancet Oncol 201973 |
| JULIET Tisa-cel | LBCL | CD19/4-1BB/LV | Flu 25 mg/m2 × 3 d Cy 250 mg/m2 × 3 d | 33% | 28% | 39% | Schuster et al. NEJM 201974 |
| TRANSCEND Liso-cel | LBCL | CD19/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 60% | 27% | 37% | Abramson et al. Lancet 202075 |
| ZUMA-7 Axi-cel | LBCL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 69% | 15% | 30% | Locke et al. NEJM 20221 |
| TRANSFORM Liso-cel | LBCL | CD19/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 82% | 50% | 52% | Abramson et al. Blood 20232 |
| ZUMA-2 Brexu-cel | MCL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 85% | 51% | 50% | Wang et al. NEJM 20204 |
| ELARA Tisa-cel | FL | CD19/4-1BB/LV | Flu 25 mg/m2 × 3 d Cy 250 mg/m2 × 3 d | 32% | 9% | 13% | Fowler et al. Nat Med 202276 |
| ZUMA-5 Axi-cel | FL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 33% | 9% | 25% | Jacobson et al. Lancet Oncol 202277 |
| KarMMa-1 Ide-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 89% | 52% | 60% | Munshi et al. NEJM 202178 |
| KarMMa-3 Ide-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 76% | 42% | 51% | Rodriguez-Otero et al. NEJM 202379 |
| CARTITUDE-1 Cilta-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 95% | 60% | 68% | Berdeja et al. Lancet 202180 |
| CARTITUDE-4 Cilta-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 90% | 41% | 36% | San-Miguel et al. NEJM 202381 |
| Trial/product . | Disease . | Target/endodomain/vector . | Lymphodepletion . | Grade ≥3 neutropenia, % . | Grade ≥3 thrombocytopenia, % . | Grade ≥3 anemia, % . | Reference . |
|---|---|---|---|---|---|---|---|
| ZUMA-3 Brexu-cel | BCP-ALL | CD19/CD28z/RV | Flu 25 mg/m2 × 3 Cy 900 mg/m2 × 1 | 27% | 30% | 49% | Shah et al. Lancet 20213 |
| ZUMA-1 Axi-cel | LBCL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 78% | 38% | 43% | Locke et al. Lancet Oncol 201973 |
| JULIET Tisa-cel | LBCL | CD19/4-1BB/LV | Flu 25 mg/m2 × 3 d Cy 250 mg/m2 × 3 d | 33% | 28% | 39% | Schuster et al. NEJM 201974 |
| TRANSCEND Liso-cel | LBCL | CD19/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 60% | 27% | 37% | Abramson et al. Lancet 202075 |
| ZUMA-7 Axi-cel | LBCL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 69% | 15% | 30% | Locke et al. NEJM 20221 |
| TRANSFORM Liso-cel | LBCL | CD19/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 82% | 50% | 52% | Abramson et al. Blood 20232 |
| ZUMA-2 Brexu-cel | MCL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 85% | 51% | 50% | Wang et al. NEJM 20204 |
| ELARA Tisa-cel | FL | CD19/4-1BB/LV | Flu 25 mg/m2 × 3 d Cy 250 mg/m2 × 3 d | 32% | 9% | 13% | Fowler et al. Nat Med 202276 |
| ZUMA-5 Axi-cel | FL | CD19/CD28z/RV | Flu 30 mg/m2 × 3 d Cy 500 mg/m2 × 3 d | 33% | 9% | 25% | Jacobson et al. Lancet Oncol 202277 |
| KarMMa-1 Ide-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 89% | 52% | 60% | Munshi et al. NEJM 202178 |
| KarMMa-3 Ide-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 76% | 42% | 51% | Rodriguez-Otero et al. NEJM 202379 |
| CARTITUDE-1 Cilta-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 95% | 60% | 68% | Berdeja et al. Lancet 202180 |
| CARTITUDE-4 Cilta-cel | MM | BCMA/4-1BB/LV | Flu 30 mg/m2 × 3 d Cy 300 mg/m2 × 3 d | 90% | 41% | 36% | San-Miguel et al. NEJM 202381 |
Cytopenias are graded according to clinical trial reporting (common terminology of adverse events—CTCAE).
Axi-cel, axicabtagene ciloleucel; BCMA, B-cell maturation antigen; BCP-ALL, B-cell precursor acute lymphoblastic leukemia; brexu-cel , brexucabtagene autoleucel; CD, cluster of differentiation; cilta-cel, ciltacabtagene autoleucel; cy, cyclophosphamide; d, day; FL, follicular lymphoma; flu, fludarabine; ide-cel, idecabtagene vicleucel; G, grade; MCL , mantle cell lymphoma; MM, multiple myeloma; LBCL , large B-cell lymphoma; LV , lentiviral vector; liso-cel , lisocabtagene maraleucel; RV, γ-retroviral vector; tisa-cel , tisagenlecleucel.