{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:13:09Z","timestamp":1788513189651,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"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":["European J of Haematology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Axicabtagene ciloleucel (Axi\u2010cel) is a chimeric antigen receptor T\u2010cell (CAR\u2010T) therapy approved for the treatment of relapsed\/refractory (R\/R) large B\u2010cell lymphoma (LBCL). The registrational phase 1\/2 ZUMA\u20101 study cohorts 1 and 4 addressed toxicity management in terms of cytokine release syndrome (CRS) and immune effector cell\u2010associated neurotoxicity syndrome (ICANS) whereby tocilizumab and corticosteroids were deployed earlier in cohort 4. In this real\u2010world, single\u2010institution study of 119 patients receiving Axi\u2010cel CAR\u2010T therapy for R\/R LBCL with 70 in cohort 1 and 49 in cohort 4, we demonstrate significantly less toxicity, intensive care unit (ICU) utilization, and cumulative steroid use with an early intervention strategy. Laboratory parameters and comorbidities did not significantly differ between groups except for a higher incidence of renal insufficiency in the cohort 4 group (28.6% vs. 4.3%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). The maximum grade CRS was significantly lower for cohort 4 versus 1 (1 vs. 2,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Furthermore, cumulative corticosteroid use was significantly less in the cohort 4 early intervention group (110\u2009mg vs. 190\u2009mg dexamethasone equivalents). These favorable findings did not have a deleterious impact on outcomes and efficacy with similar overall response rate, progression\u2010free survival, and overall survival with both toxicity management approaches.\n                  <\/jats:p>","DOI":"10.1111\/ejh.70216","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:39:14Z","timestamp":1778625554000},"page":"936-942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Experience With a\n                    <scp>ZUMA<\/scp>\n                    \u20101 Cohort 4 Adopted Approach to\n                    <scp>CRS<\/scp>\n                    and\n                    <scp>ICANS<\/scp>\n                    in\n                    <scp>CAR<\/scp>\n                    \u2010T 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