Venous Thromboembolism in Aggressive B-Cell Lymphoma Patients Treated with CD19 CAR-T Therapy: Single-Institution Study

Authors

Neha Venkatesh
Kevin Milligan
Julia Parrish
Yun Qing
Ryan Sun
Paolo Strati
Jeremy Ramdial
Amy Ayers
Sairah Ahmed
Cristhiam Rojas Hernandez

Language

English

Publication Date

2-1-2026

Journal

eJHaem

DOI

10.1002/jha2.70227

PMID

41623548

PMCID

PMC12857440

PubMedCentral® Posted Date

1-30-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Large B-cell lymphomas (LBCLs) are a common subtype of non-Hodgkin lymphomas. CD19 chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized LBCL treatment, with high remission rates but also significant toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Venous thromboembolism (VTE) in CAR-T therapy patients is understudied.

Objective: This study aims to determine the incidence and characteristics of acute VTE in LBCL patients treated with CAR-T therapy and identify baseline clinical features associated with VTE. Methods: We retrospectively reviewed 172 adult LBCL patients treated with CAR-T therapy from January 2018 to November 2019 at MD Anderson Cancer Center. Data on demographics, clinical characteristics, and adverse events were collected. VTE events within 6 months post-CAR-T therapy were confirmed by diagnostic imaging. Statistical analyses included univariate analyses and cumulative incidence functions.

Results: The cohort was predominantly male (70%), with a median age of 59 years and advanced-stage disease (76.16%). The 6-month incidence of VTE was 7.6%, primarily involving upper extremity events related to central venous catheters. Significant associations were found between VTE and disease histology (p = 0.033) and high-grade ICANS (p = 0.013). PMBCL patients had a higher VTE incidence (30%) compared to DLBCL and TFL. Most VTE events occurred within the first month post-CAR-T therapy.

Conclusion: LBCL patients receiving CAR-T therapy have a significant risk of VTE, particularly within the first month and among those with PMBCL and high-grade ICANS. This highlights the need to study the role of venous thromboprophylaxis in this context.

Published Open-Access

yes

Recommended Citation

Venkatesh, Neha; Milligan, Kevin; Parrish, Julia; et al., "Venous Thromboembolism in Aggressive B-Cell Lymphoma Patients Treated with CD19 CAR-T Therapy: Single-Institution Study" (2026). Faculty, Staff and Student Publications. 6573.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6573