Use of long-term corticosteroids in patients treated with CAR T-cell therapy.
| Autor: | Hashmi, Hamza, McGann, Mary, Greenwell, Brian I |
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| Předmět: |
THERAPEUTIC use of antineoplastic agents
NEUROTOXICOLOGY ANTICONVULSANTS ADRENOCORTICAL hormones SYNDROMES COMBINATION drug therapy TOCILIZUMAB CELL receptors POSITRON emission tomography computed tomography DIFFERENTIAL diagnosis TUMOR classification TREATMENT effectiveness CYTOKINE release syndrome DISEASE relapse CATASTROPHIC illness T cells NON-Hodgkin's lymphoma IMMUNOTHERAPY DISEASE remission |
| Zdroj: | Journal of Oncology Pharmacy Practice; Mar2023, Vol. 29 Issue 2, p473-476, 4p |
| Abstrakt: | Introduction: Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are common toxicities associated with chimeric antigen receptor (CAR) T-cell therapy. Severe grade 3 or higher ICANS is less common and requires the use of corticosteroids with or without an Interleukin (IL)-6 receptor antagonist. Although corticosteroids are effective in the management of CRS and ICANS, their impact on CAR T efficacy remains unknown. Case report: We present the case of a 65-year-old male who received CAR T-cell therapy with brexucabtagene autoleucel for stage I/II Mantle Cell Lymphoma (MCL) and achieved complete remission despite receiving a prolonged course of corticosteroids for severe ICANS. Management and outcome: The patient received treatment with high-dose corticosteroids, tocilizumab, and anakinra, in addition to multiple antiepileptic agents. Despite a remitting relapsing pattern of ICANS, the patient not only recovered from the life-threatening complication but also achieved a complete remission at three months post CAR T. Conclusion: This case describes the successful use of corticosteroids for the management of ICANS in a patient treated with CAR T-cell therapy for MCL. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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