Borrega, Jorge Garcia, Heindel, Katrin, Goereci, Yasemin, Warnke, Clemens, Onur, Oezguer A., Kochanek, Matthias, Schub, Natalie, Ayuk, Francis, Wichmann, Dominic and Boell, Boris (2021). Toxicity after chimeric antigen receptor T-cell therapy Overview and management of early and late onset side effects. Internist, 62 (6). S. 611 - 620. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1289

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Abstract

Background. The transfusion of chimeric antigen receptor (CAR) T-cells has become established as a new treatment option in oncology; however, this is regularly associated with immune-mediated side effects, which can also run a severe course and necessitate a specific treatment and intensive medical treatment. Material and methods. A literature review was carried out on CAR T-cell therapy, toxicities and the management of side effects. Results. The cytokine release syndrome (CRS) and the immune effector cell-associated neurotoxicity syndrome (ICANS) regularly occur shortly after CAR T-cell treatment. The symptoms of CRS can range from mild flu-like symptoms to multiorgan failure. In addition to mild symptoms, such as disorientation and aphasia, ICANS can also lead to convulsive seizures and brain edema. The management of CRS and ICANS is based on the severity according to the grading of the American Society for Transplantation and Cellular Therapy (ASTCT). Tocilizumab and corticosteroids are recommended for CRS and corticosteroids are used for ICANS. In the further course persisting hypogammaglobulinemia and cytopenia are frequent even months after the initial treatment and promote infections even months after CAR T-cell therapy. Discussion. Potentially severe complications regularly occur after CAR T-cell therapy. An interdisciplinary cooperation between intensive care physicians, hematologists, neurologists and specialists in other disciplines is of decisive importance for the optimal care of patients after CAR T-cell therapy.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Borrega, Jorge GarciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heindel, KatrinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goereci, YaseminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Warnke, ClemensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Onur, Oezguer A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kochanek, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schub, NatalieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ayuk, FrancisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wichmann, DominicUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boell, BorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-587226
DOI: 10.1007/s00108-021-01046-5
Journal or Publication Title: Internist
Volume: 62
Number: 6
Page Range: S. 611 - 620
Date: 2021
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1432-1289
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
NEUROTOXICITY; CD19Multiple languages
Medicine, General & InternalMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58722

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