Incidence of thrombosis in relapsed/refractory B-cell lymphoma treated with axicabtagene ciloleucel: Mayo Clinic experience
Megan Melody, Sangeetha Gandhi, Hollie Saunders, Zaid Abdel Rahman, Jacquelyn Hastings, Paula A. Lengerke-Diaz, Nicole Gannon, Tuan Truong, Matthew Hathcock, Arushi Khurana, Patrick Johnston, Stephen M. Ansell, N. Nora Bennani, Jonas Paludo, José C. Villasboas, Yucai Wang, Allison Rosenthal, James M. Foran, Ernesto Ayala, Hemant S. Murthy, Vivek Roy, Januario E. Castro, Yi Lin, Mohamed A. Kharfan‐Dabaja
Abstract
Chimeric antigen receptor (CAR) T-cell therapy is effective in relapsed/refractory large B-cell lymphoma and results in a unique toxicity profile, namely cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome. The hyper-inflammatory state associated with these toxicities has been suggested to increase the risk of thrombosis. We conducted a retrospective analysis of patients treated with axicabtagene ciloleucel (axi-cel) to assess the rate of thrombosis with axi-cel therapy from the time of CAR T-cell infusion until the end of hospitalization, when performed in the inpatient setting, or up to day +30 when performed in the outpatient setting. Ninety-two (95%) of 97 patients were hospitalized during axi-cel therapy and 85 (88%) developed CRS. Fifty-five patients (57%) received concurrent anticoagulation (53 as prophylaxis). Patients with prior VTE did not have progression or evidence of new VTE. Only 2 (2.1%) patients developed VTE. These results demonstrate a low-risk for thrombosis in axi-cel recipients.