What are the best strategies for long-term management of hematotoxicity associated with CAR-T?

During the European School of Haematology (ESH) How I manage CAR-T Therapies and Bispecific Antibodies for my Patients conference, the Lymphoma Hub spoke to Marion Subklewe, LMU, Munich, DE. We asked, What are the best strategies for long-term management of hematotoxicity associated with chimeric antigen receptor (CAR) T-cell therapy?  

 Subklewe begins by outlining findings on the high number of patients presenting with neutropenia and cytopenia post CAR-T. She goes on to identify three clinical phenotypes of neutropenia and their implications. Subklewe explains a scoring system predicting hematotoxicity, which can support risk stratification. She discusses prophylaxis regimens including aciclovir, cotrimoxazole, G-CSF immunoglobulin, and antifungals. Finally, she highlights the importance of monitoring patients after CAR-T.