Management of chimeric antigen receptor T (CAR-T) cell-associated toxicities

Intensive Care Med. 2024 Sep;50(9):1459-1469. doi: 10.1007/s00134-024-07576-4. Epub 2024 Aug 22.

Abstract

The use of chimeric antigen receptor T (CAR-T) cells is a significant therapeutic improvement increasing the prognosis for patients with a variety of hematological malignancies. However, this therapy has also sometimes life-threatening, complications. Therefore, knowledge of the treatment and management of these complications, especially in treatment centers and intensive care units, respectively, is of outstanding importance. This review provides recommendations for the diagnosis, management, and treatment of CAR-T cell-associated complications such as cytokine release syndrome, immune effector cell associated neurotoxicity syndrome, hematotoxicity, hypogammaglobulinemia, and CAR-T cell-induced pseudo-progression amongst others for physicians treating patients with CAR-T cell-associated complications and intensivists.

Keywords: CAR-T; CAR-T complications; CRS; ICAHT; ICANS; Intensive Care.

Publication types

  • Review

MeSH terms

  • Cytokine Release Syndrome* / etiology
  • Cytokine Release Syndrome* / immunology
  • Cytokine Release Syndrome* / therapy
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / therapy
  • Humans
  • Immunotherapy, Adoptive* / adverse effects
  • Immunotherapy, Adoptive* / methods
  • Neurotoxicity Syndromes / etiology
  • Receptors, Chimeric Antigen* / immunology
  • Receptors, Chimeric Antigen* / therapeutic use

Substances

  • Receptors, Chimeric Antigen