Understanding the Etiology of Pancytopenias in the CAR T-Cell Therapy Setting

Chimeric antigen receptor T-cell (CAR T-cell) therapy represents an innovative and transformative therapy for patients with relapsed and/or refractory (R/R) hematological malignancies. CAR T-cell therapy was first approved in R/R diffuse large B-cell lymphoma (DLBCL) and acute lymphoblastic leukemia, today the use of CAR T-cell therapy has expanded to multiple myeloma and other lymphoma subtypes such as follicular and mantle cell lymphoma. It is also being explored in earlier lines of therapy in DLBCL. CAR T-cell therapy is associated with a unique toxicity profile and development of cytopenias post CAR T-cell therapy has been reported in all pivotal clinical trials and is now considered a related side effect. Here, we provide an in-depth evaluation of etiologies, consequences, and current management strategies for cytopenias following CAR T-cell therapy.