{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:00:15Z","timestamp":1792036815567,"version":"4.4.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Although chimeric antigen receptor T (CAR-T) cell therapy has been indicated to be effective in treating relapsed or refractory multiple myeloma (R\/R MM), severe hematological toxicity (HT) remains an intractable issue. This study enrolled 54 patients with R\/R MM following combined infusion of anti-CD19 and anti-BCMA CAR-T cells. The results showed that the rates of severe cytopenia were high, including severe neutropenia (28\/54, 52%), severe anemia (15\/54, 28%), and severe thrombocytopenia (18\/54, 33%). Moreover, the incidence of prolonged HT (PHT) on Day 28 post-infusion was 52% (28\/54), including 46% for severe neutropenia, 30% for severe anemia, and 31% for severe thrombocytopenia. Patients with PHT had a poorer median progression-free survival (PFS) and overall survival (OS) than patients without PHT (<jats:italic>P<\/jats:italic>=0.011; <jats:italic>P<\/jats:italic>=0.007). Furthermore, Cox regression analyses showed that PHT was an independent risk factor for PFS and OS. Univariate analyses showed that IFN\u03b3 (OR: 1.046; 95% CI: 1.002-1.093, <jats:italic>P<\/jats:italic>=0.042) and severe HT after lymphodepletion chemotherapy (OR: 0.082; 95% CI: 0.017-0.404; <jats:italic>P<\/jats:italic>=0.002) were independent risk factors for PHT. In conclusion, these results indicated that PHT was associated with poor outcomes following CAR-T-cell therapy in MM patients. Early detection and management of PHT would be beneficial for the prevention of life-threatening complications and improvement in the survival of patients after CAR-T-cell therapy.<\/jats:p><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>This trial was registered on 1 May 2017 at <jats:uri>http:\/\/www.chictr.org.cn<\/jats:uri> as ChiCTR-OIC-17011272.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.1019548","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T07:31:51Z","timestamp":1666078311000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Prolonged hematological toxicity in patients receiving BCMA\/CD19 CAR-T-cell therapy for relapsed or refractory multiple 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