Figure 4.
Hematopoietic toxicity, laboratory coagulopathy, and endothelial injury in grade ≥4 CRS. (A) Minimum absolute neutrophil count, (B) hematocrit, (C) hemoglobin, and (D) platelet count are shown for patients receiving cyclophosphamide/fludarabine lymphodepletion at the indicated times after CAR T-cell infusion (n = 104). (E) Total transfused units of packed red blood cells (pRBC), platelets (Plt), and cryoprecipitate (Cryo) in the first 28 days after CAR T-cell infusion. (F) Maximum PT, (G) maximum aPTT, (H) minimum fibrinogen, and (I) maximum D-dimer concentrations are shown at the indicated times after CAR T-cell infusion. (J) The fold change in VWF concentration in serum from a subset of patients at the peak of CAR T-cell expansion (n = 60; grade 0, n = 12; grade 1-3, n = 39; grade ≥4 CRS, n = 9) compared with the VWF concentration in pooled normal plasma (12.2 μg/mL; CRYOcheck, Precision Biologic, Dartmouth, NS, Canada). (K) The Ang-2:Ang-1 ratio at the peak of CAR T-cell expansion (n = 60; grade 0, n = 12; grade 1-3, n = 39; grade ≥4 CRS, n = 9). For (A-D) and (F-I), data represent the mean ± SEM. P values were determined using the Kruskal-Wallis test. For (E,J,K), each point represents data from 1 patient. The median and IQR are shown. P values were determined using the Wilcoxon test. Gray shading indicates the normal range. ***P < .0001; **P ranges from >.0001 to <.001; *P ranges from >.001 to <.005. Gr, grade.