Bendamustine is a safe and effective lymphodepletion agent for axicabtagene ciloleucel in patients with refractory or relapsed large B-cell lymphoma.

Background: Fludarabine in combination with cyclophosphamide (FC) is the standard lymphodepletion regimen for CAR T-cell therapy (CAR T). A national fludarabine shortage in 2022 necessitated the exploration of alternative regimens with many centers employing single-agent bendamustine as lymphodepletion despite a lack of clinical safety and efficacy data. To fill this gap in the literature, we evaluated the safety, efficacy, and expansion kinetics of bendamustine as lymphodepletion prior to axicabtagene ciloleucel (axi-cel) therapy.

Incidence and risk factors associated with bleeding and thrombosis following chimeric antigen receptor T-cell therapy.

Bleeding and thrombotic events are an emerging toxicity associated with chimeric antigen receptor (CAR) therapies. To determine their incidence, we retrospectively analyzed consecutive adult patients (N = 127) with large B-cell lymphoma (LBCL) or B-cell acute lymphoblastic leukemia (B-ALL) treated from 2017 through 2020 with axicabtagene ciloleucel (axi-cel; n = 89) or a bispecific CD19/CD22 CAR (n = 38). Twelve (9.

Immune reconstitution and infectious complications following axicabtagene ciloleucel therapy for large B-cell lymphoma.

Chimeric antigen receptor (CAR) T-cell therapy targeting CD19 has significantly improved outcomes in the treatment of refractory or relapsed large B-cell lymphoma (LBCL). We evaluated the long-term course of hematologic recovery, immune reconstitution, and infectious complications in 41 patients with LBCL treated with axicabtagene ciloleucel (axi-cel) at a single center. Grade 3+ cytopenias occurred in 97.

Associated Toxicities: Assessment and Management Related to CAR T-Cell Therapy.

Background: The impressive disease response observed with chimeric antigen receptor (CAR) T-cell therapy is accompanied by the potential for unique and severe toxicities. Cytokine release syndrome (CRS) and neurologic toxicities have emerged as prominent toxicities associated with this treatment modality.

Objectives: This article presents an overview of pathophysiology, assessment, and evidence-based management of CAR T-cell therapy-associated toxicities, with particular attention paid to CRS and neurologic toxicity management.

Respiratory syncytial virus in blood and marrow transplant recipients.

Nurses caring for blood and bone marrow transplant recipients need to understand the effects that respiratory syncytial virus (RSV) infection can have on transplant recipients, family members, and healthcare providers. With knowledge about the virulence and transmission of RSV, nurses are in a position to educate patients and family, reduce nosocomial spread of the infection, and influence clinical practice. By recognizing specific risk factors for infection, nurses can act as gatekeepers who identify candidates to screen and enhance early detection of infection.