{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:15:18Z","timestamp":1789017318481,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Immune effector cell-associated hematotoxicity (ICAHT) is a frequent adverse event after chimeric antigen receptor (CAR)-T cell therapy. Grade \u2265 3 thrombocytopenia occurs in around one-third of patients, and many of them become platelet transfusion-dependent. Eltrombopag is a thrombopoietin receptor agonist (TPO-RA) able to accelerate megakaryopoiesis, which has been used successfully in patients with bone marrow failure and immune thrombocytopenia (ITP). Its role in managing thrombocytopenia and other cytopenias in CAR-T cell-treated patients has been scarcely addressed. Our aim was to report the safety and efficacy of this approach in patients included in the Spanish Group for Hematopoietic Transplantation and Cellular Therapy (GETH-TC) registry. Methods: This is a retrospective, multicenter, observational study. Patients who developed platelet transfusion dependence subsequently to CAR-T cells and received eltrombopag to improve platelet counts were recruited in 10 Spanish hospitals. Results: Thirty-eight patients were enrolled and followed up for a median (interquartile range [IQR]) of 175 (99, 489) days since CAR-T cell infusion. At the moment eltrombopag was indicated, 18 patients had thrombocytopenia and another severe cytopenia, while 8 patients had severe pancytopenia. After 32 (14, 38) days on eltrombopag, 29 (76.3%) patients recovered platelet transfusion independence. The number of platelet units transfused correlated with the time needed to restore platelet counts higher than 20 \u00d7 109\/L (Rho = 0.639, p &lt; 0.001). Non-responders to eltrombopag required more platelet units (58 [29, 69] vs. 12 [6, 26] in responders, p = 0.002). Nineteen out of twenty-three (82.6%) patients recovered from severe neutropenia after 22 (11, 31) days on eltrombopag. Twenty-nine out of thirty-five (82.9%) patients recovered red blood cell (RBC) transfusion independence after 29 (17, 44) days. Seven patients recovered all cell lineages while on treatment. No thromboembolic events were reported. Only two transient toxicities (cholestasis, hyperbilirubinemia) were reported during eltrombopag treatment, none of which compelled permanent drug withdrawal. Conclusions: Eltrombopag could be safely used to manage thrombocytopenia and accelerate transfusion independence in CAR-T cell-treated patients.<\/jats:p>","DOI":"10.3390\/jcm13175117","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T03:40:39Z","timestamp":1724902839000},"page":"5117","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Use of Eltrombopag to Improve Thrombocytopenia and Tranfusion Requirement in Anti-CD19 CAR-T Cell-Treated Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9083-855X","authenticated-orcid":false,"given":"Maria-Eva","family":"Mingot-Castellano","sequence":"first","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla, IBiS\/CSIC, Universidad de Sevilla, 41004 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6408-1747","authenticated-orcid":false,"given":"Juan Luis","family":"Reguera-Ortega","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla, IBiS\/CSIC, Universidad de Sevilla, 41004 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Zafra Torres","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Hernani","sequence":"additional","affiliation":[{"name":"INCLIVA Health Research Institute, Hospital Cl\u00ednico Universitario, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriana","family":"Lopez-Godino","sequence":"additional","affiliation":[{"name":"Hematology Department, Centro Regional de Hemodonaci\u00f3n, IMIB-Pascual Parrilla, Hospital Universitario Morales-Meseguer, 30008 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5978-2578","authenticated-orcid":false,"given":"Manuel","family":"Guerreiro","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario y Polit\u00e9cnico La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Herrero","sequence":"additional","affiliation":[{"name":"Hospital Infantil Universitario del Ni\u00f1o Jes\u00fas, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"L\u00f3pez-Corral","sequence":"additional","affiliation":[{"name":"IBSAL, CIBERONC, Centro de Investigaci\u00f3n del C\u00e1ncer-IBMCC (USAL-CSIC), Hospital Universitario de Salamanca (Spain), 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2201-3091","authenticated-orcid":false,"given":"Alejandro","family":"Luna","sequence":"additional","affiliation":[{"name":"Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesli","family":"Gonzalez-Pinedo","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Gran Canaria Dr. Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6291-4612","authenticated-orcid":false,"given":"Anabelle","family":"Chinea-Rodriguez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Africa-Mart\u00edn","sequence":"additional","affiliation":[{"name":"IBSAL, CIBERONC, Centro de Investigaci\u00f3n del C\u00e1ncer-IBMCC (USAL-CSIC), Hospital Universitario de Salamanca (Spain), 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeca","family":"Bailen","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8688-1202","authenticated-orcid":false,"given":"Nuria","family":"Martinez-Cibrian","sequence":"additional","affiliation":[{"name":"Hospital Clinic Barcelona, Institut de Recerca Sant Joan de D\u00e9u, Barcelona Hospital Sant Joan de D\u00e9u, 08950 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascual","family":"Balsalobre","sequence":"additional","affiliation":[{"name":"University Hospital Vall d\u2019Hebron, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Filaferro","sequence":"additional","affiliation":[{"name":"University Hospital Vall d\u2019Hebron, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3195-5470","authenticated-orcid":false,"given":"Anna","family":"Alonso-Saladrigues","sequence":"additional","affiliation":[{"name":"Institut de Recerca Sant Joan de D\u00e9u,  Hospital Sant Joan de D\u00e9u, 08950 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Barba","sequence":"additional","affiliation":[{"name":"Grupo Espa\u00f1ol de Trasplante Hematopoy\u00e9tico y Terapia Celular, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6436-9195","authenticated-orcid":false,"given":"Antonio","family":"Perez-Martinez","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology Department, La Paz University Hospital, 28034 Madrid, Spain"},{"name":"Pediatric Department, Autonomous University of Madrid, 28034 Madrid, Spain"},{"name":"CIBERER-ISCIII, IdiPAZ-CNIO Pediatric OncoHematology Clinical Research Unit, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8106-4863","authenticated-orcid":false,"given":"Mar\u00eda","family":"Calbacho","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3616-6101","authenticated-orcid":false,"given":"Jose Antonio","family":"Perez-Sim\u00f3n","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla, IBiS\/CSIC, Universidad de Sevilla, 41004 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9181-0900","authenticated-orcid":false,"given":"Jose Maria","family":"S\u00e1nchez-Pina","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Spanish Group of Hematopoietic Transplant and Cell Therapy (GETH-TC)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1056\/NEJMp1711886","article-title":"Tragedy, Perseverance, and Chance\u2014The Story of 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