{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:31:48Z","timestamp":1790659908104,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Corticosteroids are commonly used to manage cytokine release syndrome (CRS) and immune effector cell\u2013associated neurotoxicity syndrome (ICANS) following chimeric antigen receptor (CAR) T\u2010cell therapy, and yet, their dose\u2010specific impact on outcomes remains uncertain. We retrospectively evaluated 276 adults with large B\u2010cell lymphoma (LBCL) treated with CD19\u2010directed CAR\u2010T therapy (axi\u2010cel, tisa\u2010cel, or liso\u2010cel) between 2016 and 2023 at a single institution. Cumulative corticosteroid dose was defined as the total dose administered within 21 days of infusion. Corticosteroids were administered to 105 patients (38%), initiated at a median of 5 days post\u2010infusion (interquartile range [IQR] 3\u20137) for CRS (38%), ICANS (15%), or both (47%). Use was more frequent with axi\u2010cel (P\u2009&lt;\u20090.001), although the cumulative dose and duration were similar across products. To assess the impact of corticosteroid exposure, we carried out a 21\u2010day landmark analysis. Corticosteroid exposure, modeled as a time\u2010dependent covariate, was not significantly associated with infection risk, non\u2010relapse mortality, or inferior overall survival (OS) or progression\u2010free survival (PFS). However, in a landmark analysis, patients receiving above\u2010median cumulative corticosteroid doses had a significantly higher risk of infection compared to those receiving below\u2010median corticosteroid doses or no corticosteroids (P\u2009=\u20090.042). In a landmark multivariable analysis, corticosteroid cumulative dose was associated with increased late hematologic toxicity (adjusted hazard ratio [HR] 1.02, 95% CI 1.02\u20131.03). Finally, in a sensitivity analysis excluding patients with Grade \u22654 CRS\/ICANS, corticosteroid cumulative dose remained unassociated with OS or relapse, but was linked to shorter PFS (adjusted HR 1.04, 95% CI 1.01\u20131.06). These findings support the safe yet judicious use of corticosteroids to manage CAR\u2010T toxicities in LBCL.<\/jats:p>","DOI":"10.1002\/hem3.70248","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T09:01:13Z","timestamp":1764234073000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patterns and safety of glucocorticosteroid use following CD19 CAR\u2010T therapy for large B\u2010cell lymphoma"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0212-2135","authenticated-orcid":false,"given":"Efrat","family":"Luttwak","sequence":"first","affiliation":[{"name":"Department of Medicine, Lymphoma Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Department of Medicine Weill Cornell Medical College New York New York 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United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Cassanello","sequence":"additional","affiliation":[{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"IRCCS San Raffaele Scientific Institute, Lymphoma Unit Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Corona","sequence":"additional","affiliation":[{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Hematology Service Hospital 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Luan","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medical College New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parastoo B.","family":"Dahi","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medical College New York New York United\u00a0States"},{"name":"Department of Medicine Cellular Therapy Service, Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro Luna De","family":"Abia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Bone Marrow Transplantation and Cell Therapy Unit Hematology Service, Hospital Universitario Ramon y Cajal Madrid 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine Cellular Therapy Service, Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeniffer K.","family":"Lue","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lymphoma Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Department of Medicine Cellular Therapy Service, Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia M.","family":"Palomba","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lymphoma Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Department of Medicine Weill Cornell Medical College New York New York United\u00a0States"},{"name":"Department of Medicine Cellular Therapy Service, Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae H.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medical College New York New York United\u00a0States"},{"name":"Department of Medicine Cellular Therapy Service, Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep S.","family":"Raj","sequence":"additional","affiliation":[{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Rejeski","sequence":"additional","affiliation":[{"name":"Department of Medicine, Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"},{"name":"Department of Medicine III\u2010Hematology\/Oncology LMU University Hospital, LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Rivas Delgado","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lymphoma Service Memorial Sloan Kettering Cancer Center New York New York United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Scordo","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medical College New York New York 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