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Granulocyte colony-stimulating factor (G-CSF) is often used to mitigate neutropenia after CAR T, but there is no consensus recommended strategy due to hypothesized, but largely unknown risks of exacerbating toxicities. To investigate the impact of G-CSF, we retrospectively analyzed 197 patients treated with anti-CD19 CAR T for lymphoma and 47 patients treated with anti-BCMA CAR T for multiple myeloma. In lymphoma, 140 patients (71%) received prophylactic G-CSF before CAR T (mostly pegylated G-CSF) and were compared with 57 patients (29%) treated with G-CSF after CAR T or not exposed. Prophylactic G-CSF was associated with faster neutrophil recovery (3 vs. 4 days, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) but did not reduce recurrent neutropenia later. Prophylactic G-CSF was associated with increased grade \u22652 CRS (HR 2.15, 95% CI 1.11\u20134.18, <jats:italic>P<\/jats:italic>\u2009=\u20090.02), but not ICANS. In multiple myeloma, prophylactic G-CSF was not used; patients were stratified by early G-CSF exposure (\u22642 days vs. \u22653 days after CAR T or no exposure), with no significant difference in toxicities. Future trials should clarify the optimal G-CSF strategy to improve outcomes after CAR T.<\/jats:p>","DOI":"10.1038\/s41408-022-00741-2","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T02:02:39Z","timestamp":1667268159000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Effect of granulocyte colony-stimulating factor on toxicities after CAR T cell therapy for lymphoma and myeloma"],"prefix":"10.1038","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-5570","authenticated-orcid":false,"given":"Kevin Charles","family":"Miller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Connor","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy S.","family":"Abramson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob D.","family":"Soumerai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Yee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Branagan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4042-1526","authenticated-orcid":false,"given":"Elizabeth K.","family":"O\u2019Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Saucier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caron A.","family":"Jacobson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Frigault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3066-1275","authenticated-orcid":false,"given":"Noopur S.","family":"Raje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,1]]},"reference":[{"key":"741_CR1","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1056\/NEJMoa1709919","volume":"378","author":"JH Park","year":"2018","unstructured":"Park JH, Rivi\u00e8re I, Gonen M, Wang X, S\u00e9n\u00e9chal B, Curran KJ, et al. 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PCJ reports consulting fees from AstraZeneca. JSA reports consulting fees from Bristol-Myers Squibb, Kite Pharma, Genentech, Genmab, and Regeneron. JDS reports research funding from Beigene, BostonGene, Genentech\/Roche, GlaxoSmithKline, Moderna, and TG Therapeutics, and consulting fees from Abbvie, AstraZeneca, Beigene, Biogen, Bristol Myers Squibb, Roche, TG Therapeutics, and Verastem. AJY reports consulting fees from AbbVie, Adaptive Biotechnologies, Amgen, Bristol-Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Karyopharm, Oncopeptides, Regeneron, Sanofi, and Takeda. ARB reports consulting fees from Adaptive Biotechnologies, BeiGene, CSL Behring, Genzyme, Karyopharm, Pharmacyclics, and Sanofi. EKO reports consulting fees from Bristol-Myers Squibb, Janssen, Sanofi, Pfizer, and Takeda. AS reports no conflicts of interest. CAJ reports consulting fees from Bluebird, BMS\/Celgene, Daiichi-Sankyo, Epizyme, ImmPACT Bio, Instill Bio, Ipsen, Kite\/Gilead, Lonza, Novartis, and research funding from Kite\/Gilead and Pfizer. MJF reports consulting fees from Arcellx, Bristol-Myers Squibb, Kite\/Gilead, Iovance, and Novartis. NSR reports consulting fees from Bristol-Myers Squibb and Janssen.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"146"}}