{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T08:33:36Z","timestamp":1794472416598,"version":"4.9.1"},"reference-count":40,"publisher":"American Society of Hematology","issue":"7","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,14]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Immune effector cell\u2013associated hematotoxicity (ICAHT) was recently introduced as a distinct toxicity category of chimeric antigen receptor (CAR) T-cell (CAR-T) therapy. Although a grading system based solely on neutrophil counts was proposed (hereafter termed N-ICAHT), the prevalence and prognostic impact of thrombocytopenia remain poorly defined. In this multicenter observational study, we systematically examined patterns of thrombocytopenia in 744 patients treated with commercial CD19 CAR-T for B-cell non-Hodgkin lymphoma (B-NHL). We developed a grading system termed T-ICAHT, with thresholds that closely aligned with N-ICAHT, based on depth, duration, and timing of thrombocytopenia. In the core NHL data set, 43% of patients developed any-grade early T-ICAHT (days 0-30), with 23% developing severe (grade \u22653) manifestations. Late T-ICAHT (days 31-100) was observed in 42% (grade \u22653, 13%). Although T-ICAHT and N-ICAHT gradings showed some correlation, considerable discordance was noted. On multivariate analysis, bridging therapy, poor performance status, and high HEMATOTOX scores were associated with increased risk of severe early T-ICAHT. Patients with higher T-ICAHT grades showed increased platelet and red blood cell transfusion burden and more bleeding events. T-ICAHT grades were inversely associated with overall survival (OS), with landmarked 2-year estimates ranging from 67% (grade 0) to 48% (grade 1-2) and 35% (grade \u22653). In multivariable Cox regression analysis, the independent prognostic capacity of T-ICAHT for OS was confirmed. Finally, we validated T-ICAHT\u2019s clinical and prognostic utility in 3 external cohorts spanning an additional 599 pediatric and adult patients (NHL, multiple myeloma, and B-cell acute lymphoblastic leukemia), confirming its broad applicability. These findings support integrating T-ICAHT into the ICAHT framework to standardize thrombocytopenia grading in CAR-T recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2025028833","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T15:30:42Z","timestamp":1745249442000},"page":"834-846","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":49,"title":["T-ICAHT: grading and prognostic impact of thrombocytopenia after CAR T-cell therapy"],"prefix":"10.1182","volume":"146","author":[{"given":"Kai","family":"Rejeski","sequence":"first","affiliation":[{"name":"1Adult Bone Marrow Transplant Service, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"2Cellular Therapy Service, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"3Department of Medicine III, Ludwig Maximilian University Hospital, Ludwig Maximilian University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6934-4619","authenticated-orcid":false,"given":"Jaime","family":"Sanz","sequence":"additional","affiliation":[{"name":"1Adult Bone Marrow Transplant Service, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"4Departament de Medicina, Universitat de Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7888-1715","authenticated-orcid":false,"given":"Teng","family":"Fei","sequence":"additional","affiliation":[{"name":"5Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica S.","family":"Nair","sequence":"additional","affiliation":[{"name":"6Pediatric Oncology Branch, Center for Cancer 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