Multicenter study of risk of myeloid neoplasms after CD19-directed CAR T-cell therapy for B cell lymphoma

Therapy-related myeloid neoplasms (t-MN), including myelodysplastic neoplasms (t-MDS) and acute myeloid leukemia (t-AML), have emerged as late complications after CAR T cell therapy. A retrospective study at 4 centers in France found that after CAR T cell therapy for B cell lymphoma, the cumulative incidence of t-MN was 4.5% at 2 years (68% t-MDS and 32% t-AML) . Median overall survival after t-MN diagnosis was 4.5 months. In propensity score matched analysis, higher mean corpuscular volume and higher grade immune effector cell-associated neurotoxicity syndrome were associated with higher risk of t-MN. The authors conclude that t-MN is a severe late complication of CAR T cell therapy for B cell lymphoma.