{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:56:55Z","timestamp":1792673815476,"version":"4.5.0"},"reference-count":29,"publisher":"American Society of Hematology","issue":"11","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title\/>\n                  <jats:p>Immune effector cell\u2013associated hematotoxicity (ICAHT) is a major B-cell targeted chimeric antigen receptor (CAR) T-cell related toxicity. Although ICAHT incidence and severity is documented in large B-cell lymphoma (LBCL), mantle cell lymphoma (MCL), and multiple myeloma (MM), ICAHT has not been described in B-cell acute lymphoblastic leukemia (B-ALL). Similarly, the CAR-HEMATOTOX (CAR-HT) model, designed to predict severe prolonged neutropenia (\u226514 days of absolute neutrophil count [ANC] &amp;lt;500\/\u03bcL), has been validated in LBCL, MCL, and MM, but not in B-ALL. As B-ALL bone marrow (BM) infiltration can impact cytopenias, we sought to describe ICAHT and assess CAR-HT for predicting hematotoxicity in B-ALL. In a cohort of 156 children and young adults with relapsed\/refractory B-ALL, the median duration of severe neutropenia (ANC &amp;lt;500\/\u03bcL) was 13 days (95% confidence interval, 10-16 days), with 83 (53%) experiencing grade \u22653 ICAHT. Applying CAR-HT, nearly 90% were classified as high risk, demonstrating limited discriminative power and prompting further development. Using the association identified between BM disease burden and postinfusion neutropenia (r\u00a0=\u00a00.64, P\u00a0&amp;lt; .0001), we developed the ALL-Hematotox (ALL-HT) score, which substitutes BM disease burden for ferritin in CAR-HT. The ALL-HT score associated with severe prolonged neutropenia (area under the curve\u00a0=\u00a00.84, P\u00a0&amp;lt; .0001), and appropriately discriminated high-risk patients (47%) who had more cumulative days of neutropenia (26 vs 4 days; P\u00a0&amp;lt; .0001), fewer rates of complete response (88% vs 98%; P\u00a0=\u00a0.03), and shorter median overall survival (9.8 vs 24 months; log-rank P\u00a0=\u00a0.0002). ALL-HT was also validated in 2 independent cohorts. The ALL-HT score refines a widely accepted predictive model of postinfusion hematotoxicity, which is applicable in B-ALL.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1182\/blood.2024025910","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T20:29:45Z","timestamp":1732048185000},"page":"1136-1148","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":35,"title":["Development of ALL-Hematotox: predicting post-CAR T-cell hematotoxicity in B-cell acute lymphoblastic leukemia"],"prefix":"10.1182","volume":"145","author":[{"given":"Monica S.","family":"Nair","sequence":"first","affiliation":[{"name":"1Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD"},{"name":"2Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara 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