{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:46:10Z","timestamp":1793997970522,"version":"4.8.0"},"reference-count":29,"publisher":"American Society of Hematology","issue":"13","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Cytokine release syndrome (CRS) immune effector cell\u2013associated neurotoxicity syndrome are the most notable toxicities of CD19 chimeric antigen receptor (CAR) T-cell therapy. In addition, CAR T-cell\u2013mediated toxicities can involve any organ system, with varied impacts on outcomes, depending on patient factors and involved organs. We performed detailed analysis of organ-specific toxicities and their association with outcomes in 60 patients with diffuse large B-cell lymphoma (DLBCL) treated with CD19 CAR T cells by assessing all toxicities in organ-based groups during the first year posttreatment. We observed 539 grade \u22652 and 289 grade \u22653 toxicities. Common grade \u22653 toxicities included hematological, metabolic, infectious, and neurological complications, with corresponding 1-year cumulative incidence of 57.7%, 54.8%, 35.4%, and 18.3%, respectively. Patients with impaired performance status had a higher risk of grade \u22653 metabolic complications, whereas elevated lactate dehydrogenase was associated with higher risks of grade \u22653 neurological and pulmonary toxicities. CRS was associated with higher incidence of grade \u22653 metabolic, pulmonary, and neurologic complications. The 1-year nonrelapse mortality and overall survival were 1.7% and 69%, respectively. Only grade \u22653 pulmonary toxicities were associated with an increased mortality risk. In summary, toxicity burdens after CD19 CAR T-cell therapy were high and varied by organ systems. Most toxicities were manageable and were rarely associated with mortality. Our study emphasizes the importance of toxicity assessment, which could serve as a benchmark for further research to reduce symptom burdens and improve tolerability in patients treated with CAR T cells.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020001972","type":"journal-article","created":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T15:39:53Z","timestamp":1593704393000},"page":"3024-3033","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":137,"title":["DLBCL patients treated with CD19 CAR T cells experience a high burden of organ toxicities but low nonrelapse mortality"],"prefix":"10.1182","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-8681","authenticated-orcid":false,"given":"Kitsada","family":"Wudhikarn","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Division of Hematology and"},{"name":"Research Unit in Translational Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Pennisi","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Division of Hematology, Oncology, Hemato-oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori\/University of Milan, Milan, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Garcia-Recio","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8310-6684","authenticated-orcid":false,"given":"Jessica R.","family":"Flynn","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Epidemiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-3283","authenticated-orcid":false,"given":"Aishat","family":"Afuye","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari Lynne","family":"Silverberg","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly A.","family":"Maloy","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M.","family":"Devlin","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Epidemiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9036-9463","authenticated-orcid":false,"given":"Connie Lee","family":"Batlevi","sequence":"first","affiliation":[{"name":"Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9977-0456","authenticated-orcid":false,"given":"Gunjan L.","family":"Shah","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Scordo","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lia","family":"Palomba","sequence":"first","affiliation":[{"name":"Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0794-3226","authenticated-orcid":false,"given":"Parastoo B.","family":"Dahi","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig S.","family":"Sauter","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca D.","family":"Santomasso","sequence":"first","affiliation":[{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"},{"name":"Department of Neurology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Mead","sequence":"first","affiliation":[{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"},{"name":"Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5910-4571","authenticated-orcid":false,"given":"Miguel-Angel","family":"Perales","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2020,7,2]]},"reference":[{"issue":"1","key":"2020070211394609500_B1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/nrclinonc.2017.128","article-title":"Chimeric antigen receptor T-cell therapies for lymphoma","volume":"15","author":"Brudno","year":"2018","journal-title":"Nat Rev Clin Oncol"},{"issue":"39","key":"2020070211394609500_B2","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1200\/EDBK_238691","article-title":"The other side of CAR T-cell therapy: cytokine release syndrome, neurologic toxicity, and financial burden","volume":"39","author":"Santomasso","year":"2019","journal-title":"Am Soc Clin Oncol Educ Book"},{"issue":"1","key":"2020070211394609500_B3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s40425-018-0343-9","article-title":"Cytokine release syndrome","volume":"6","author":"Shimabukuro-Vornhagen","year":"2018","journal-title":"J Immunother Cancer"},{"key":"2020070211394609500_B4","unstructured":"US Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/CTCAE_v5_Quick_Reference_8.5x11.pdf. 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