Use of Eltrombopag to Improve Thrombocytopenia and Transfusion Requirement in Anti-CD19 Car-T Cell-Treated Patients

How to cite: Mingot-Castellano, M.-E.; Reguera-Ortega, J. L.; Zafra Torres, D.; Hernani, R.; Lopez-Godino, O.; Guerreiro, M.; Herrero, B.; Lopez-Corral, L.; Luna, A.; González-Pinedo, L.; Chinea-Rodriguez, A.; Martin-lópez, A. A.; Bailen, R.; Martinez-Cebrian, N.; Balsalobre, P.; Filaferro, S.; Alonso-Saladrigues, A.; Barba, P.; Pérez-Martínez, A.; Calbacho, M.; Perez Simon, J. A.; Sanchez-Pina, J. M. Use of Eltrombopag to Improve Thrombocytopenia and Transfusion Requirement in Anti-CD19 Car-T Cell-Treated Patients. Preprints 2024, 2024072382. https://doi.org/10.20944/preprints202407.2382.v1 Mingot-Castellano, M.-E.; Reguera-Ortega, J. L.; Zafra Torres, D.; Hernani, R.; Lopez-Godino, O.; Guerreiro, M.; Herrero, B.; Lopez-Corral, L.; Luna, A.; González-Pinedo, L.; Chinea-Rodriguez, A.; Martin-lópez, A. A.; Bailen, R.; Martinez-Cebrian, N.; Balsalobre, P.; Filaferro, S.; Alonso-Saladrigues, A.; Barba, P.; Pérez-Martínez, A.; Calbacho, M.; Perez Simon, J. A.; Sanchez-Pina, J. M. Use of Eltrombopag to Improve Thrombocytopenia and Transfusion Requirement in Anti-CD19 Car-T Cell-Treated Patients. Preprints 2024, 2024072382. https://doi.org/10.20944/preprints202407.2382.v1

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Mingot-Castellano, M.-E.; Reguera-Ortega, J. L.; Zafra Torres, D.; Hernani, R.; Lopez-Godino, O.; Guerreiro, M.; Herrero, B.; Lopez-Corral, L.; Luna, A.; González-Pinedo, L.; Chinea-Rodriguez, A.; Martin-lópez, A. A.; Bailen, R.; Martinez-Cebrian, N.; Balsalobre, P.; Filaferro, S.; Alonso-Saladrigues, A.; Barba, P.; Pérez-Martínez, A.; Calbacho, M.; Perez Simon, J. A.; Sanchez-Pina, J. M. Use of Eltrombopag to Improve Thrombocytopenia and Transfusion Requirement in Anti-CD19 Car-T Cell-Treated Patients. Preprints 2024, 2024072382. https://doi.org/10.20944/preprints202407.2382.v1

APA Style

Mingot-Castellano, M. E., Reguera-Ortega, J. L., Zafra Torres, D., Hernani, R., Lopez-Godino, O., Guerreiro, M., Herrero, B., Lopez-Corral, L., Luna, A., González-Pinedo, L., Chinea-Rodriguez, A., Martin-lópez, A. A., Bailen, R., Martinez-Cebrian, N., Balsalobre, P., Filaferro, S., Alonso-Saladrigues, A., Barba, P., Pérez-Martínez, A., Calbacho, M., Perez Simon, J. A., & Sanchez-Pina, J. M. (2024). Use of Eltrombopag to Improve Thrombocytopenia and Transfusion Requirement in Anti-CD19 Car-T Cell-Treated Patients. Preprints. https://doi.org/10.20944/preprints202407.2382.v1

Chicago/Turabian Style

Mingot-Castellano, M., Jose Antonio Perez Simon and Jose Maria Sanchez-Pina. 2024 "Use of Eltrombopag to Improve Thrombocytopenia and Transfusion Requirement in Anti-CD19 Car-T Cell-Treated Patients" Preprints. https://doi.org/10.20944/preprints202407.2382.v1

Abstract

Abstract Background/Objectives Immune effector cell-associated hematotoxicity (ICAHT) is a frequent adverse event after chimeric antigen receptor (CAR)-T cell therapy. Grade ≥3 thrombocytopenia occurs in around one third of patients, many of whom become platelet transfusion-dependent. Without pharmacological support, platelet recovery may last for months. Eltrombopag is a thrombopoietin receptor agonist (TPO-RA) able to accelerate megakaryopoiesis, which has been used successfully in patients with bone marrow failure and immune thrombocytopenia (ITP.) Its role to manage thrombocytopenia, and other cytopenias, in CAR-T cell-treated patients has been scarcely addressed in the real-world setting. Our aim was to report the Feasibility of this approach and the outcome of patients included in the GETH-TC registry. Methods This is a retrospective, multicenter, observational study. Patients who developed platelet transfusion-dependence subsequently to CAR-T cell treatment were recruited in 10 Spanish hospitals and followed-up for at least 30 days after the first dose of eltrombopag was administered. Results Thirty-eight patients were enroled and followed-up for a median (interquartile range [IQR]) of 175 (99, 489) days since CAR-T cell infusion. At eltrombopag start, 18 patients had thrombocytopenia and another severe cytopenia, while 8 patients had severe pancytopenia. After 32 (14, 38) days on eltrombopag, 29 (76.3%) patients recovered platelet transfusion independence. The number of platelet units used correlated with the time needed to restore platelet counts to levels 20x109/L (Rho = 0.639, p

Keywords

CAR-T; Thrombocytopenia; Platelet transfusion; Neutropenia; Red blood cell transfusion; Pancytopenia; Thrombopoietin receptor agonist; Eltrombopag; Adverse events

Subject

Medicine and Pharmacology, Hematology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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