| Autor: |
Pensato, Umberto, Pondrelli, Federica, de Philippis, Chiara, Asioli, Gian Maria, Crespi, Alessandra, Buizza, Alessandro, Mannina, Daniele, Casadei, Beatrice, Maffini, Enrico, Straffi, Laura, Marcheselli, Simona, Zinzani, Pier Luigi, Bonifazi, Francesca, Guarino, Maria, Bramanti, Stefania |
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| Zdroj: |
Neurological Sciences; Aug2024, Vol. 45 Issue 8, p4007-4014, 8p |
| Abstrakt: |
Introduction: Seizures may occur in up to 30% of non-Hodgkin lymphoma patients who received anti-CD19 CAR T-cell therapy, yet the optimal anti-seizure medication (ASM) prevention strategy has not been thoroughly investigated. Methods: Consecutive patients affected by refractory non-Hodgkin lymphoma who received anti-CD19 CAR T-cells were included. Patients were selected and assessed using similar internal protocols. ASM was started either as a primary prophylaxis (PP-group) before CAR T-cells infusion or as a pre-emptive therapy (PET-group) only upon the onset of neurotoxicity development. Results: One hundred fifty-six patients were included (PP-group = 88, PET-group = 66). Overall, neurotoxicity and severe neurotoxicity occurred in 45 (29%) and 20 (13%) patients, respectively, equally distributed between the two groups. Five patients experienced epileptic events (PET-group = 3 [4%]; PP-group = 2 [2%]). For all the PET-group patients, seizure/status epilepticus occurred in the absence of overt CAR-T-related neurotoxicity, whereas patients in the PP-group experienced brief seizures only in the context of critical neurotoxicity with progressive severe encephalopathy. ASMs were well-tolerated by all patients, even without titration. No patients developed epilepsy or required long-term ASMs. Conclusion: Our data suggest that both primary and pre-emptive anti-seizure prophylaxis are safe and effective in anti-CD19 CAR T-cell recipients. Clinical rationale suggests a possible more favourable profile of primary prophylaxis, yet no definitive conclusion of superiority between the two ASM strategies can be drawn from our study. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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