免疫效应细胞相关血液毒性 (ICAHT) 是一种常见的毒性，与嵌合抗原受体 (CAR)-T 细胞治疗后的重要发病率相关。严重ICAHT的发生似乎涉及多种因素，导致其治疗变得困难。在这里，我们报告了三例在 axicabtagene-ciloleucel (axi-cel) 治疗弥漫性大 B 细胞淋巴瘤后出现严重 ICAHT 的病例，显示骨髓中大颗粒淋巴细胞扩张，且具有 CD3/CD57 阳性非 CAR-T 免疫表型。我们证明，可以用低剂量类固醇治疗它们，显着解决血细胞减少症，同时对潜在的恶性肿瘤没有有害影响。© 2024 作者。英国血液学杂志由英国血液学会和约翰·威利出版

Immune effector cell-associated hematotoxicity (ICAHT) is a common toxicity associated with an important morbidity after chimeric antigen receptor (CAR)-T-cell therapy. Multiple factors seem to be involved in the development of severe ICAHT, making its management difficult. Here, we report three cases of severe ICAHT after axicabtagene-ciloleucel (axi-cel) for diffuse large B-cell lymphoma showing an expansion of large granular lymphocyte in the bone marrow with a CD3/CD57-positive non-CAR-T immunophenotype. We show that it is possible to treat them with low-dose steroids, obtaining a striking resolution of cytopenias with no deleterious impact on the underlying malignancy.© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.