Clinical features, pathophysiology, and management of acute myelopathy following CAR T-cell therapy Review
| Authors: | Deschênes-Simard, X.; Santomasso, B. D.; Dahi, P. B. |
| Review Title: | Clinical features, pathophysiology, and management of acute myelopathy following CAR T-cell therapy |
| Abstract: | Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of patients with relapsed or refractory hematologic malignancies, but it comes with unique toxicities, notably cytokine release syndrome and ICANS (immune effector cell–associated neurotoxicity syndrome). As experience with CAR T-cell therapy grows, distinct and infrequent neurologic complications are becoming increasingly evident. Recently, reports of acute myelopathy after the administration of CAR T-cell therapies have been accumulating. Despite the establishment of consensus guidelines for managing ICANS, there remains limited guidance on the appropriate investigations and treatments for this rare complication. In this manuscript, we delve into the clinical features, pathophysiology, and strategies for the optimal management of acute myelitis after CAR T-cell therapy and draw insights from reported cases in the literature. © 2024 American Society of Hematology |
| Keywords: | clinical feature; review; pathophysiology; neurotoxicity; immunology; hematologic malignancy; hematologic neoplasms; drug combination; diagnosis; chimeric antigen receptor; disease management; clinical practice guideline; drug therapy; neurological complication; therapy; adoptive immunotherapy; immunotherapy, adoptive; hematologic disease; intravenous drug administration; spinal cord disease; acute disease; etiology; adverse event; spinal cord diseases; cytokine release syndrome; myelitis; procedures; humans; human; chimeric antigen receptor t-cell immunotherapy; receptors, chimeric antigen |
| Journal Title: | Blood |
| Volume: | 144 |
| Issue: | 20 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2024-11-14 |
| Start Page: | 2083 |
| End Page: | 2094 |
| Language: | English |
| DOI: | 10.1182/blood.2024025679 |
| PUBMED: | 39226460 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- MSK corresponding author is Deschênes-Simard -- Source: Scopus |
