Coagulation Disorder and Relevant Factors Analysis after Chimeric Antigen Receptor T Cell Therapy in Hematological Malignancies

doi:10.3969/j.issn.1671-2587.2021.03.016

JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE ›› 2021, Vol. 23 ›› Issue (3): 364-370.DOI: 10.3969/j.issn.1671-2587.2021.03.016

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Coagulation Disorder and Relevant Factors Analysis after Chimeric Antigen Receptor T Cell Therapy in Hematological Malignancies

XU Qian-wen, XUE Lei, WANG Min, et al

Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001

Received:2021-01-11 Online:2021-06-20 Published:2021-06-22

Abstract

Abstract: Objective To explore coagulation disorder and relevant factors in patients with B cell hematological malignancies after CD19 targeted chimeric antigen receptor (CAR)-T cell therapy. Methods We retrospectively enrolled 46 patients with relapsed/refractory (R/R) B cell hematological malignancies from October 2016 to January 2020, and the changes of coagulation parameters after CAR-T therapy were collected and analyzed. Results Among 46 patients, 37 (80.4%) patients occurred coagulation disorders, including elevated D-dimer [ (>5 mg/L) (31/46, 67.4%)], prolonged APTT [ (> 10s) (25/46, 54.3%)], prolonged TT (19/46, 41.3%), decreased fibrinogen concentration [(<1.5 g/L) (22/46, 47.8%)], prolonged PT [ (>3s) (7/46, 15.2% )], and elevated FDP [ (> 20 mg/L (12/18, 66.7%)). Correlation analysis showed that coagulation disorder were associated with dose escalation, the level of inflammatory factors after infusion, and the severity of cytokine release syndrome (CRS) after infusion. Conclusion Coagulation disorder is a common adverse event after CAR-T therapy. Dose escalation infusion can reduce the risk of coagulopathy, and the severity of CRS is significantly associated with coagulopathy.

Key words: Hematological malignancies, Chimeric antigen receptor, CD19, Cytokine release syndrome Coagulopathy

CLC Number:

R331.1⁺43

XU Qian-wen, XUE Lei, WANG Min, et al. Coagulation Disorder and Relevant Factors Analysis after Chimeric Antigen Receptor T Cell Therapy in Hematological Malignancies[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(3): 364-370.

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Coagulation Disorder and Relevant Factors Analysis after Chimeric Antigen Receptor T Cell Therapy in Hematological Malignancies

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