[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-448190-105":59,"doc-detail-448190-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","after-car-t-therapy-for-myeloma-challenge-of-persistent-cytopenias-and-infections","After CAR-T therapy for myeloma - challenge of persistent cytopenias and infections","","Editorial discussing the clinical challenges after CAR-T therapy in relapsed/refractory multiple myeloma, emphasizing persistent cytopenias and infections. It summarizes findings from a multicenter retrospective study on cilta-cel and contrasts them with earlier ide-cel data, detailing risks, contributing factors, and the timeline of hematologic recovery. It also reviews immunity changes and supportive interventions such as G-CSF, transfusions, thrombopoietin agonists, and stem cell boosts, alongside infection-related non-relapse mortality trends.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/after-car-t-therapy-for-myeloma-challenge-of-persistent-cytopenias-and-infections/448190/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/after-car-t-therapy-for-myeloma-challenge-of-persistent-cytopenias-and-infections/448190.png","ImageObject",300,407,{"name":92,"@type":93},"Theodore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What are the main complications after CAR-T therapy for multiple myeloma highlighted in the editorial?","Question",{"text":112,"@type":113},"Persistent cytopenias and infections are presented as key complications, with cytopenias often continuing for months and infections contributing substantially to non-relapse mortality.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did the multicenter retrospective study on cilta-cel show about severe cytopenias over time?",{"text":117,"@type":113},"More than half of patients had severe cytopenias by day 30 after infusion, with nearly a quarter still affected by day 90.",{"name":119,"@type":110,"acceptedAnswer":120},"Which supportive therapies and interventions were evaluated alongside cilta-cel, and how did stem cell boost perform?",{"text":121,"@type":113},"The study analyzed G-CSF, blood transfusions, thrombopoietin agonists, and CD34+ stem cell boost; among patients receiving a stem cell boost, all except one responded with a median hematologic recovery time of 21 days.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},448190,1790795146,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},7971461740886,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","EDITORIAL  \nAfter CAR-T therapy for myeloma: challenge of persistent cytopenias and infections  \nOfrat Beyar-Katz1,2 and Anat Stern2,3  \n1 Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus; 2The Ruth and Bruce Rappaport Faculty of Medicine, Technion and 3 Department of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel  \nCorrespondence: O. Beyar-Katz  \n[o_katz@rmc.gov.il](o_katz@rmc.gov.il)  \nReceived: August 1, 2025.  \nAccepted: August 11, 2025.  \nEarly view: August 21, 2025.  \n[https://doi.org/10.3324/haematol.2025.288539](https://doi.org/10.3324/haematol.2025.288539)  \n©2026 Ferrata Storti Foundation  \nPublished under a CC BY-NC license   \nThe advent of chimeric antigen receptor (CAR) T-cell therapy represents a dramatic breakthrough in the management of relapsed/refractory multiple myeloma (MM), offering hope to patients exhausted by multiple lines of treatment. Two CAR T-cell products idecabtagene vicleucel (ida-cel) and ciltacabtagene autoleucel (cilta-cel) received endorsement from the U.S. Food and Drug Administration and the European Medicines Agency in 2021 and 2022, based on results of the pivotal KarMMa and CARTITUDE-1 trials, which were the first to demonstrate remarkable efficacy of these products. However, these studies also underscored the significant risk of cytopenias and infections, common adverse events creating compelling clinical challenges. In the current issue of Haematologica, Dima [et al](et al. report)[. report](et al. report)[ ](et al. report)results of a multicenter retrospective study, providing much-awaited insights into short-and long-term hematologic and infectious complications associated with cilta-cel, based on the data obtained outside the setting of controlled clinical trials 1 The study’s findings were quite sobering: over half of the patients experienced severe cytopenias at day 30 after infusion, with nearly a quarter of them remaining affected at day 90 (Figure 1) . Similarly, in an earlier study by the same group, treatment with standard-of-care ide-cel appeared to be associated with severe cytopenias documented in 58% and 31% of patients at days 30 and 90, respectively.2 Such persistence of cytopenias emphasizes the need for close monitoring and consideration of the application of supportive care well beyond the initial treatment period. The identified risk factors for severe cytopenia included baseline extramedullary disease, high-risk cytogenetics, more than four lines of prior therapy, existing cytopenia at apheresis or before lymphodepletion, a high CAR-HEMATOTOX score, and tocilizumab use (Figure 1) .  \nWhile the pathophysiology of long-term cytopenia is considered multifactorial, recently reported evidence suggests that B-cell maturation antigen (BCMA) CAR T cells may exert  \na paracrine effect on the differentiation of hematopoietic stem and progenitor cells, promoting the development of more immature cell phenotypes.3 Not unexpectedly, findings of a recently published analysis unequivocally demonstrate that persistent cytopenias, especially anemia and neutropenia, occurring at various timepoints following BCMA therapy in relapsed/refractory MM patients, portenda poor prognosis, as reflected by significantly reduced progression-free survival and overall survival.4 The study by Dima et al. also explored immunity changes following cilta-cel administration and analyzed the use of essential supportive therapies, including granulocyte colony-stimulating factor (65% of patients), blood transfusion (38%), thrombopoietin agonists (10%), and a CD34+ stem cell boost (9.5%) . Importantly, among patients receiving a stem cell boost (N=10), all except one responded to the therapy, with a median time to hematologic recovery of 21 days (range, 6-96 days) . These findings further support the value of this approach, particularly in MM, in which many patients have stem cells available for reinfusion. Infections are another well-recognized hallmark co","cbCaih5TB3yxC2iF","https://ap.wps.com/l/cbCaih5TB3yxC2iF","pdf",444855,"English","# Editorial overview\n## Cytopenias after cilta-cel and ide-cel\n## Risk factors and monitoring needs\n## Immunity changes and supportive care\n## Infection burden and evolving immune vulnerability","[{\"question\":\"What are the main complications after CAR-T therapy for multiple myeloma highlighted in the editorial?\",\"answer\":\"Persistent cytopenias and infections are presented as key complications, with cytopenias often continuing for months and infections contributing substantially to non-relapse mortality.\"},{\"question\":\"What did the multicenter retrospective study on cilta-cel show about severe cytopenias over time?\",\"answer\":\"More than half of patients had severe cytopenias by day 30 after infusion, with nearly a quarter still affected by day 90.\"},{\"question\":\"Which supportive therapies and interventions were evaluated alongside cilta-cel, and how did stem cell boost perform?\",\"answer\":\"The study analyzed G-CSF, blood transfusions, thrombopoietin agonists, and CD34+ stem cell boost; among patients receiving a stem cell boost, all except one responded with a median hematologic recovery time of 21 days.\"}]","After CAR-T therapy for myeloma - challenge of persistent cytopenias and infections | PDF",1790725923]