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Prolonged cytopenias and infections represent common and clinically relevant side effects. In this multicenter observational study, we describe cytopenias and infections in 103 r\/r MCL patients receiving brexu\u2010cel. Furthermore, we report associations between the baseline CAR\u2010HEMATOTOX (HT) score and toxicity events, non\u2010relapse mortality (NRM), and progression\u2010free\/overall survival (PFS\/OS). At lymphodepletion, 56 patients were HT<jats:sup>low<\/jats:sup> (score 0\u20131) while 47 patients were HT<jats:sup>high<\/jats:sup> (score \u22652). The HT<jats:sup>high<\/jats:sup> cohort exhibited prolonged neutropenia (median 14 vs. 6\u2009days, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and an increased rate of severe infections (30% vs. 5%, <jats:italic>p<\/jats:italic>\u2009=\u2009.001). Overall, 1\u2010year NRM was 10.4%, primarily attributed to infections, and differed by baseline HT score (high vs. low: 17% vs. 4.6%, <jats:italic>p<\/jats:italic>\u2009=\u2009.04). HT<jats:sup>high<\/jats:sup> patients experienced inferior 90\u2010day complete response rate (68% vs. 93%, <jats:italic>p<\/jats:italic>\u2009=\u2009.002), PFS (median 9\u2009months vs. not\u2010reached, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001), and OS (median 26\u2009months vs. not\u2010reached, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). Multivariable analyses showed that high HT scores were independently associated with severe hematotoxicity, infections, and poor PFS\/OS. In conclusion, infections and hematotoxicity are common after brexu\u2010cel and contribute to NRM. The baseline HT score identified patients at increased risk of poor treatment outcomes.<\/jats:p>","DOI":"10.1002\/ajh.27056","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T05:45:40Z","timestamp":1692423940000},"page":"1699-1710","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["The <scp>CAR\u2010HEMATOTOX<\/scp> score identifies patients at high risk for hematological toxicity, infectious complications, and poor treatment outcomes following brexucabtagene autoleucel for relapsed or refractory <scp>MCL<\/scp>"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-0251","authenticated-orcid":false,"given":"Kai","family":"Rejeski","sequence":"first","affiliation":[{"name":"Department of Medicine III \u2013 Hematology\/Oncology, LMU University Hospital LMU Munich  Munich Germany"},{"name":"Laboratory for Translational Cancer Immunology LMU Gene 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Cl\u00ednico Universitario de Salamanca, IBSAL, CIBERONC  Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n del C\u00e1ncer\u2010IBMCC  Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Ries","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Pneumology, University Medical Center Johannes Gutenberg University  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit L.","family":"B\u00fccklein","sequence":"additional","affiliation":[{"name":"Department of Medicine III \u2013 Hematology\/Oncology, LMU University Hospital LMU Munich  Munich Germany"},{"name":"Laboratory for Translational Cancer Immunology LMU Gene Center  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razan","family":"Mohty","sequence":"additional","affiliation":[{"name":"Department of Blood and Marrow Transplant and Cellular Immunotherapy Moffitt Cancer Center  Tampa 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