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To explore risk factors for hemorrhage after CAR T-cell therapy, we retrospectively analyzed routine indicators in 56 patients with non-Hodgkin lymphoma and B-cell acute lymphoblastic leukemia who received anti-CD19 CAR T-cell therapy. Disturbance of coagulation occurred mainly within one month post infusion, especially on day 7 and 14. The cumulative incidence of bleeding events within one month was 32.8%, with the median onset of 7 (range, 0\u201328) days. All bleeding events were grade 1\u20133. Patients who experienced bleeding events within one month had longer prothrombin time, higher IL-6, higher IL-10, and lower platelets before lymphodepletion. There were also correlations among coagulation-, inflammatory-, and tumor burden-related markers. Multi-variate analysis showed IL-10 (&gt; 7.98 pg\/mL; adjusted odds ratio [OR], 13.84; 95% confidence interval [CI], 2.03\u201394.36; <jats:italic>P<\/jats:italic> = 0.007) and the endothelial activation and stress index (EASIX, defined as dehydrogenase [U\/L] \u00d7 creatinine [mg\/dL] \/ platelets [\u00d710<jats:sup>9<\/jats:sup> cells\/L]; &gt;7.65; adjusted OR, 7.06; 95% CI, 1.03\u201348.23; <jats:italic>P<\/jats:italic> = 0.046) were significant risk factors for bleeding events. IL-10 plus the EASIX defined three risk groups for bleeding events with cumulative incidence of 100% (hazard ratio [HR], 14.47; 95% CI, 2.78\u201375.29; <jats:italic>P<\/jats:italic> &lt; 0.0001), 38.5% (HR, 3.68; 95% CI, 0.82\u201316.67; <jats:italic>P<\/jats:italic> = 0.089), and 11.8% (reference), respectively. Future studies are needed to verify the risk assessment models for bleeding events after CAR T-cell treatment in larger cohorts.<\/jats:p>","DOI":"10.1007\/s00277-023-05477-y","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T22:03:10Z","timestamp":1696888990000},"page":"3575-3585","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["IL-10 plus the EASIX score predict bleeding events after anti-CD19 CAR T-cell therapy"],"prefix":"10.1007","volume":"102","author":[{"given":"Xindi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenggong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinqiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongpei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7941-2443","authenticated-orcid":false,"given":"Heng","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,9]]},"reference":[{"issue":"1","key":"5477_CR1","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/S1470-2045(18)30864-7","volume":"20","author":"FL Locke","year":"2019","unstructured":"Locke FL, Ghobadi A, Jacobson CA, Miklos DB, Lekakis LJ, Oluwole OO, Lin Y, Braunschweig I, Hill BT, Timmerman JM, Deol A, Reagan PM, Stiff P, Flinn IW, Farooq U, Goy A, McSsweeney PA, Munoz J, Siddiqi T et al (2019) Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1\u20132 trial. 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