Fig. 1

Overview of CAR T-cell mediated hematotoxicity and infectious complications. a Treatment course prior to CAR T-cell therapy. b Timeline of infectious complications during CAR T-cell treatment course. Positive microbiologic culture results are underlined. Bottom: Overview of utilized anti-infectives with the respective bars displaying the length of treatment. P/T = piperacillin/tazobactam, Ami = amikacin, Mero = meropenem, Vanco = vancomycin, Line = linezolid, Posa = posaconazole (p.o.), Mica = micafungin (i.v.), Amb = liposomal amphotericin B. The patient also received prophylactic acyclovir and sulfamethoxazole/trimethoprim (TMP/SMZ) during treatment. c Complete Blood Count (CBC) timeline. ANC (blue), platelet count (green), Hemoglobin (red). Transfusion events (green: platelet transfusion, red: pRBC transfusion) and G-CSF support (blue bar) are integrated in the curve. d Dynamics of Serum Inflammatory Markers. Infectious complications are superimposed above the graph. e Histopathologic analysis of BM biopsies demonstrating severe BM aplasia 1 month after CAR T-cell transfusion (Day 32, upper panel) and evidence of recovering hematopoiesis following autologous stem cell transfer (Autopsy, lower panel). Immunohistochemical staining for myeloperoxidase (= MPO) highlighting strong activation of myelopoiesis (right panel)