Extended Data Fig. 3: Associations of pre-CAR-T cell infusion antibiotic exposure, tumor burden, performance status, CAR-T cell product and peripheral blood phenotypes.

Serum levels of LDH (a) in German and US patients at the time point of lymphodepletion chemotherapy stratified by whether patients received none or low-risk antibiotics (US: n = 83, Germany: n = 49) versus high-risk antibiotics (US: n = 20: Germany: n = 16). (b) Serum levels of CRP in German and US patients at the time point of lymphodepletion chemotherapy stratified by whether patients received none or low-risk antibiotics versus high-risk antibiotics. (c) IL-6 serum levels in patients at the day of CAR-T cell infusion (none | LR antibiotics: n = 67; HR antibiotics: n = 18). (d) Histograms of the frequencies of bulky lymphomas (>10 cm by radiological measurement), or (e) ECOG performance status according to antibiotic risk stratification. (f) Histograms of the frequencies of antibiotic exposures, or (g) ECOG performance status (left), or ICANS grades (right) according to type of CAR-T cell product administered to the patients. (h) Peripheral blood CD3, CD4 and CD8 T cell counts at the time point of leukapheresis displayed separately for US and German patients. (i) Blood T cell counts stratified by the number of treatment lines prior to CD19-directed CAR-T cell therapy (≤ 3: n = 53; ≥ 4: n = 39). (j and k) FACS analyses of peripheral blood T cell subsets of CAR-T cell-treated patients from Moffitt Cancer Center at the time of leukocyte apheresis and stratified by antibiotic exposure (none | LR antibiotics: n = 39; HR antibiotics: n = 12). CD4 and CD8 stem central memory (SCM; CCR7+, CD45RO-), central memory (CM; CCR7+, CD45RO+), effector memory (EM; CCR7-, CD45RO+), and effector (E; CCR7-CD45RO-) subsets are shown. Statistics for A-C, H, I, K by Mann–Whitney tests, for E-G by Fisher’s exact tests.