Universität zu Köln

Azoulay, Elie, Shimabukuro-Vornhagen, Alexander, Darmon, Michael and von Bergwelt-Baildon, Michael (2019). Critical Care Management of Chimeric Antigen Receptor T Cell-related Toxicity Be Aware and Prepared. Am. J. Respir. Crit. Care Med., 200 (1). S. 20 - 24. NEW YORK: AMER THORACIC SOC. ISSN 1535-4970

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Abstract

CAR (chimeric antigen receptor) T cells (CARTs) are genetically engineered T cells that express CARs, with impressive clinical activity in relapsed and refractory hematologic malignancies, primarily acute lymphoblastic leukemia and diffuse large B-cell lymphoma. The most frequent life-threatening adverse events after CART infusion are cytokine release syndrome and CAR-related encephalopathy syndrome, which can occur within hours or days after administration. IL-6 released by macrophages and monocytes plays a major role in the pathogenesis of cytokine release syndrome and CAR-related encephalopathy syndrome, and IL-6 blockade and steroids contribute to fast resolution of symptoms. Critical care management plays an important role in patients receiving CARTs, as up to half of patients might need an admission to the ICU and lifesaving interventions. As new treatment indications and CART constructs enter the clinic, the number of patients requiring ICU admission will rapidly increase, with profound consequences for the use of ICU resources, training requirements, clinical expertise, multidisciplinary collaboration, and hospital organization. Research is also needed to validate at large scale biomarkers that allow doctors to risk-stratify patients for both their risk to develop severe toxicity and their likelihood to respond to therapy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Azoulay, Elie UNSPECIFIED UNSPECIFIED UNSPECIFIED Shimabukuro-Vornhagen, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Darmon, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bergwelt-Baildon, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-136125
DOI:	10.1164/rccm.201810-1945ED
Journal or Publication Title:	Am. J. Respir. Crit. Care Med.
Volume:	200
Number:	1
Page Range:	S. 20 - 24
Date:	2019
Publisher:	AMER THORACIC SOC
Place of Publication:	NEW YORK
ISSN:	1535-4970
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Critical Care Medicine; Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13612