Severe persistent neurotoxicity associated with CAR T therapy in children.

Autor: Andrew EC; Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia., Hughes D; Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia., Gilsenan M; Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia., Mignone C; Medical Imaging Department, Royal Children's Hospital, Parkville, Victoria, Australia., Khaw SL; Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia.; Murdoch Children's Research Institute, Parkville, Victoria, Australia.; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia., Wang SS; Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia.; Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2023 Nov; Vol. 203 (4), pp. 651-655. Date of Electronic Publication: 2023 Aug 01.
DOI: 10.1111/bjh.19015
Abstrakt: CD19-directed chimeric antigen receptor (CAR) T-cell therapy is an important therapy for relapsed or refractory acute lymphoblastic leukaemia, but its use carries the risk of immune effector cell-associated neurotoxicity syndrome (ICANS). In children, severe ICANS is almost universally reported in association with cytokine release syndrome and is reversible. We describe two cases of severe, intractable neurotoxicity following CAR T-cell therapy in children with pre-existing central nervous system (CNS) vulnerabilities. The cases were atypical in their delayed onset and independence from cytokine release syndrome and did not respond to standard therapies.
(© 2023 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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