TY  - JOUR
A1  - Kiem, Dominik
A1  - Leisch, Michael
A1  - Neureiter, Daniel
A1  - Haslauer, Theresa
A1  - Egle, Alexander
A1  - Melchardt, Thomas
A1  - Topp, Max S.
A1  - Greil, Richard
T1  - Two cases of pancytopenia with Coombs-negative hemolytic anemia after chimeric antigen receptor T-cell therapy
JF  - International Journal of Molecular Sciences
N2  - Background: Chimeric antigen receptor (CAR) T-cells are changing the therapeutic landscape of hematologic malignancies. Severe side effects include cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), but prolonged cytopenia has also been reported. The underlying mechanism for prolonged cytopenia is poorly understood so far. Cases: Severe pancytopenia with grade 2-3 anemia was marked 2–3 months after treatment. Laboratory evaluation revealed undetectable levels of haptoglobin with increased reticulocyte counts. Coomb's tests were negative, no schistocytes were detected on blood smear, and infectious causes were ruled out. Increased erythropoiesis without lymphoma infiltration was noted on bone marrow biopsy. A spontaneous increase in haptoglobin and hemoglobin levels was observed after several weeks. For one patient, peripheral CAR-T levels were monitored over time. We observed a decline at the same time as hemoglobin levels began to rise, implying a potential causality. Conclusion: To our knowledge, we describe the first two cases of Coombs-negative hemolytic anemia after CAR-T treatment for B-cell lymphoma. We encourage routine monitoring for hemolytic anemia after CAR-T treatment and also encourage further investigations on the underlying mechanism.
KW  - CAR T-cell
KW  - hemolytic anemia
KW  - prolonged cytopenia
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-284977
SN  - 1422-0067
VL  - 22
IS  - 11
ER  - 
TY  - JOUR
A1  - Bonig, Halvard
A1  - Kuçi, Zyrafete
A1  - Kuçi, Selim
A1  - Bakhtiar, Shahrzad
A1  - Basu, Oliver
A1  - Bug, Gesine
A1  - Dennis, Mike
A1  - Greil, Johann
A1  - Barta, Aniko
A1  - Kállay, Krisztián M.
A1  - Lang, Peter
A1  - Lucchini, Giovanna
A1  - Pol, Raj
A1  - Schulz, Ansgar
A1  - Sykora, Karl-Walter
A1  - Teichert von Luettichau, Irene
A1  - Herter-Sprie, Grit
A1  - Ashab Uddin, Mohammad
A1  - Jenkin, Phil
A1  - Alsultan, Abdulrahman
A1  - Buechner, Jochen
A1  - Stein, Jerry
A1  - Kelemen, Agnes
A1  - Jarisch, Andrea
A1  - Soerensen, Jan
A1  - Salzmann-Manrique, Emilia
A1  - Hutter, Martin
A1  - Schäfer, Richard
A1  - Seifried, Erhard
A1  - Paneesha, Shankara
A1  - Novitzky-Basso, Igor
A1  - Gefen, Aharon
A1  - Nevo, Neta
A1  - Beutel, Gernot
A1  - Schlegel, Paul-Gerhardt
A1  - Klingebiel, Thomas
A1  - Bader, Peter
T1  - Children and adults with Refractory acute Graft-versus-Host Disease respond to treatment with the Mesenchymal Stromal cell preparation “MSC-FFM”—Outcome report of 92 patients
JF  - Cells
N2  - (1) Background: Refractory acute graft-versus-host disease (R-aGvHD) remains a leading cause of death after allogeneic stem cell transplantation. Survival rates of 15% after four years are currently achieved; deaths are only in part due to aGvHD itself, but mostly due to adverse effects of R-aGvHD treatment with immunosuppressive agents as these predispose patients to opportunistic infections and loss of graft-versus-leukemia surveillance resulting in relapse. Mesenchymal stromal cells (MSC) from different tissues and those generated by various protocols have been proposed as a remedy for R-aGvHD but the enthusiasm raised by initial reports has not been ubiquitously reproduced. (2) Methods: We previously reported on a unique MSC product, which was generated from pooled bone marrow mononuclear cells of multiple third-party donors. The products showed dose-to-dose equipotency and greater immunosuppressive capacity than individually expanded MSCs from the same donors. This product, MSC-FFM, has entered clinical routine in Germany where it is licensed with a national hospital exemption authorization. We previously reported satisfying initial clinical outcomes, which we are now updating. The data were collected in our post-approval pharmacovigilance program, i.e., this is not a clinical study and the data is high-level and non-monitored. (3) Results: Follow-up for 92 recipients of MSC-FFM was reported, 88 with GvHD ≥°III, one-third only steroid-refractory and two-thirds therapy resistant (refractory to steroids plus ≥2 additional lines of treatment). A median of three doses of MSC-FFM was administered without apparent toxicity. Overall response rates were 82% and 81% at the first and last evaluation, respectively. At six months, the estimated overall survival was 64%, while the cumulative incidence of death from underlying disease was 3%. (4) Conclusions: MSC-FFM promises to be a safe and efficient treatment for severe R-aGvHD.
KW  - graft-versus host
KW  - transplantation
KW  - mesenchymal stromal cell
KW  - cell therapy
KW  - hospital exemption
KW  - steroid-resistant aGvHD
KW  - refractory aGvHD
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-193878
SN  - 2073-4409
VL  - 8
IS  - 12
ER  -