Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of patients with relapsed or refractory hematologic malignancies, but it comes with unique toxicities, notably cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). As experience with CAR T-cell therapy grows, distinct and infrequent neurological complications are becoming increasingly evident. Recently, reports of acute myelopathy following the administration of CAR T-cell therapies have been accumulating. Despite the establishment of consensus guidelines for managing ICANS, there remains limited guidance on appropriate investigations and treatments for this rare complication. Here, we delve into the clinical features, pathophysiology, and strategies for optimally managing acute myelitis after CAR T-cell therapy, drawing insights from reported cases in the literature.
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Review Article|
September 3, 2024
Clinical features, pathophysiology, and management of acute myelopathy following CAR T-cell therapy
Xavier Deschenes-Simard,
Memorial Sloan Kettering Cancer Center (MSKCC), New York, New York, United States
* Corresponding Author; email: deschex1@mskcc.org
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Bianca D. Santomasso,
Bianca D. Santomasso
MSKCC, New York, New York, United States
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Parastoo B. Dahi
Parastoo B. Dahi
MSKCC, New York, New York, United States
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Blood blood.2024025679.
Article history
Submitted:
June 10, 2024
Revision Received:
August 28, 2024
Accepted:
August 28, 2024
Citation
Xavier Deschenes-Simard, Bianca D. Santomasso, Parastoo B. Dahi; Clinical features, pathophysiology, and management of acute myelopathy following CAR T-cell therapy. Blood 2024; blood.2024025679. doi: https://doi.org/10.1182/blood.2024025679
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