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Dryad

Bone marrow Single cell sequencing data of CAR-T treated IL-2Ra -/- mice

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Sep 12, 2025 version files 122.09 GB

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Abstract

Despite breakthrough research and success in CAR-T therapy in heme malignancies, adverse events caused during CAR-T infusion remain a challenge. Among the various toxicities, the co-occurrence of cytokine release syndrome (CRS) along with neutropenia is the leading cause of severe life-threatening infections, increased hospitalizations, and the leading cause of non-relapse mortality. To this end, we developed an IL-2R alpha knockout model (where exons 2 and 3 that bind to IL-2 are replaced by a neomycin resistance gene) that showed the recapitulation of CRS and neutropenia seen in the clinic. This novel pre-clinical model helped us identify IFNg (one of the CRS-associated cytokines) to drive this co-occurrence. Through adoptive transfer studies, we show that excess IFNg released during CAR-T expansion triggers the inflammatory cascade that fuels the etiology of both CRS and neutropenia by triggering Th1/Th17 imbalance. IFNg is a Th1 cytokine that inhibits Th17 differentiation, which is crucial for neutrophil regulation. To corroborate the impact of IFNg on CRS-neutropenia, we processed bone marrow samples of tumor-bearing IL-2Rα -/- mice treated with CAR-T (Group 1) and IFNγ -/- CAR-T (Group 2) in the presence or absence of Th17 (Group 4) and Th1 cells (Group 5). The samples were processed for sequencing at week 4 post CAR-T infusion to study the mechanistic underpinnings of the impact of IFNg blockade on neutrophils and macrophages (M1 macrophages are known to drive CRS) that are involved in CRS and neutropenia co-occurrence during CAR-T therapy.