{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:52:35Z","timestamp":1791204755173,"version":"4.2.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    While cytokine release syndrome (CRS) and immune effector cell\u2013associated neurotoxicity syndrome (ICANS) are well\u2010recognized toxicities of CAR T\u2010cell therapy, immune effector cell\u2010associated hemophagocytic lymphohistiocytosis\u2010like syndrome (IEC\u2010HS) remains poorly characterized. We aimed to describe the incidence, clinical features, management, and outcomes of IEC\u2010HS using real\u2010world data from the DESCAR\u2010T registry (NCT04328298). We conducted a multicenter retrospective study of patients registered in DESCAR\u2010T who received standard\u2010of\u2010care CD19 CAR T\u2010cell therapy for relapsed or refractory B\u2010cell non\u2010Hodgkin lymphoma (B\u2010NHL) or B\u2010cell acute lymphoblastic leukemia (B\u2010ALL) and fulfilled ASTCT criteria for IEC\u2010HS. We analyzed 42 patients who developed IEC\u2010HS. Most had a high CAR\u2010HEMATOTOX score (\u22652,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200936) and prior high\u2010grade CRS (grade \u22653,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200920). IEC\u2010HS was characterized by marked hyperinflammation, with high median ferritin (18,561\u2009\u00b5g\/L), lactate dehydrogenase (825\u2009IU\/L), and triglycerides (4.5\u2009g\/L), and low fibrinogen (0.9\u2009g\/L). Median time to IEC\u2010HS onset was 9 days (IQR 6\u201321). Patients received a median of two treatment lines. Observed response rates were 77% with etoposide, 70% with corticosteroids, 70% with corticosteroids plus anakinra, and 50% with tocilizumab, with combination therapy more frequently used in severe cases. After a median follow\u2010up of 24.1 months, overall mortality was 81%. One\u2010year overall survival was 15.6% for B\u2010NHL and 47.1% for B\u2010ALL. In this real\u2010world cohort, IEC\u2010HS was a rare but life\u2010threatening complication of CD19 CAR T\u2010cell therapy, often occurring after severe CRS and associated with poor outcomes. Despite initial inflammatory control, mortality remained high, underscoring the need for improved risk stratification and management strategies.\n                  <\/jats:p>","DOI":"10.1002\/hem3.70425","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T13:15:03Z","timestamp":1784380503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemophagocytic lymphohistiocytosis\u2010like syndrome after CD19\u2010directed CAR T\u2010cells for B\u2010cell lymphoma and B\u2010cell acute lymphoblastic leukemia: A LYSA, SFCE, and GRAALL study from the DESCAR\u2010T registry"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2359-8440","authenticated-orcid":false,"given":"Nicolas","family":"Gower","sequence":"first","affiliation":[{"name":"Clinical Hematology Claude Huriez University Hospital Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roch","family":"Houot","sequence":"additional","affiliation":[{"name":"Clinical Hematology Rennes University Hospital Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Pizot","sequence":"additional","affiliation":[{"name":"LYSARC biostatistical team Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Baruchel","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Robert Debr\u00e9 University Hospital Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Emilie","family":"Dourthe","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Robert Debr\u00e9 University Hospital Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Beauvais","sequence":"additional","affiliation":[{"name":"Clinical Hematology Claude Huriez University Hospital Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Gastinne","sequence":"additional","affiliation":[{"name":"Clinical Hematology Nantes University Hospital Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Brisou","sequence":"additional","affiliation":[{"name":"Clinical Hematology Paoli Calmette Institut, Marseilles  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9my","family":"Dulery","sequence":"additional","affiliation":[{"name":"Clinical Hematology Saint Antoine Hospital Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Guidez","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Poitiers University Hospital Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Jacques","family":"Tudesq","sequence":"additional","affiliation":[{"name":"Clinical and Intensive Care Unit of Hematology, Montpellier University Hospital Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Chauchet","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Besan\u00e7on University Hospital Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Herbreteau","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Brest University Hospital Brest France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Campidelli","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Nancy University Hospital Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques\u2010Olivier","family":"Bay","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Clermont\u2010Ferrand University Hospital Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-822X","authenticated-orcid":false,"given":"Pierre","family":"Sesques","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Hospices Civils de Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmond","family":"Chiche","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Nice University Hospital Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois\u2010Xavier","family":"Gros","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Bordeaux University Hospital Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandine","family":"Durand","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Francois Mitterrand Hospital Dijon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Lubnau","sequence":"additional","affiliation":[{"name":"Pediatric Hematology, Nancy University Hospital Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Sterin","sequence":"additional","affiliation":[{"name":"Pediatric Hematology, Marseille Timone Hospital Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Di Blasi","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Saint Louis Hospital Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Marquet","sequence":"additional","affiliation":[{"name":"LYSARC biostatistical team Lyon 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Saint\u2010Louis Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Morschhauser","sequence":"additional","affiliation":[{"name":"Clinical Hematology Claude Huriez University Hospital Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Paillassa","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Angers University Hospital Angers 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CAR T cell single\u2010cell multiomic features associated with immune effector cell\u2010associated hemophagocytic lymphohistiocytosis\u2010like syndrome (IEC\u2010HS). 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