Neuro-toxicities of chemo- and immune-therapies in haematologic malignancies: from mechanism to management

David Kegyes; Vlad Moisoiu; Catalin Constantinescu; Alina Tanase; Gabriel Ghiaur; Hermann Einsele; Ciprian Tomuleasa; Hillard M Lazarus; Robert Peter Gale

doi:10.1016/j.blre.2024.101254

Neuro-toxicities of chemo- and immune-therapies in haematologic malignancies: from mechanism to management

Blood Rev. 2024 Dec 11:101254. doi: 10.1016/j.blre.2024.101254. Online ahead of print.

Authors

David Kegyes¹, Vlad Moisoiu², Catalin Constantinescu¹, Alina Tanase³, Gabriel Ghiaur⁴, Hermann Einsele⁵, Ciprian Tomuleasa⁶, Hillard M Lazarus⁷, Robert Peter Gale⁸

Affiliations

¹ Department of Hematology, Ion Chiricuta Cancer Center, Cluj-Napoca, Romania; Department of Hematology / Department of Personalized Medicine and Rare Diseases - Medfuture Institute for Biomedical Research, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
² Department of Hematology / Department of Personalized Medicine and Rare Diseases - Medfuture Institute for Biomedical Research, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Neurology and Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.
³ Department of Stem Cell Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
⁴ Department of Hematology / Department of Personalized Medicine and Rare Diseases - Medfuture Institute for Biomedical Research, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Leukemia, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
⁵ Department of Hematology / Department of Personalized Medicine and Rare Diseases - Medfuture Institute for Biomedical Research, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Internal Medicine, Julius Maximilians University of Wurzburg, Wurzburg, Germany.
⁶ Department of Hematology, Ion Chiricuta Cancer Center, Cluj-Napoca, Romania; Department of Hematology / Department of Personalized Medicine and Rare Diseases - Medfuture Institute for Biomedical Research, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. Electronic address: [email protected].
⁷ Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
⁸ Centre for Haematology, Imperial College of Science, Technology and Medicine, London, UK; Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.

PMID: 39674687
DOI: 10.1016/j.blre.2024.101254

Abstract

Chemo- and immune therapies administered to treat haematologic malignancies frequently cause neurologic injury. The adverse events range from mild cognitive impairment and headaches to severe conditions such as seizures, stroke and encephalitis. We performed a comprehensive literature review and report the types, mechanisms, management and prevention of neuro-toxicity resulting from these therapies in subjects who develop these toxic effects. Our paper will not discuss radiation therapy, as it has already been extensively reviewed by many authors. Our focus will be on recently developed anti-cancer drugs.

Keywords: Antibody therapy; Antibody-drug conjugates; CNS; Chemotherapy; Chimeric antigen receptor; Immunotherapy; Neuro-toxicity.

Publication types

Review