Chimeric antigen receptor T-cell neuropsychiatric toxicity in acute lymphoblastic leukemia. Issue 4 (4th January 2017)

• Record Type: Journal Article
• Authors: Prudent, Vasthie; Breitbart, William S.
• Is Part Of: Palliative & supportive care. Volume 15:Issue 4(2017)
• Page Start: 499
• Page End: 503
• Publication Date: 2017-01-04
• Subjects: Chimeric antigen receptor, -- Neurotoxicity, -- Cytokine release syndrome, -- Acute lymphoblastic leukemia; Palliative treatment -- Great Britain -- Periodicals; 616.029
• DOI: 10.1017/S147895151600095X
• Languages: English
• ISSNs: 1478-9515

Abstract

ABSTRACT: Chimeric antigen receptor T cells are used in the treatment of B-cell leukemias. Common chimeric antigen receptor T-cell toxicities can range from mild flu-like symptoms, such as fever and myalgia, to a more striking neuropsychiatric toxicity that can present as discrete neurological symptoms and delirium. We report here two cases of chimeric antigen receptor T-cell neuropsychiatric toxicity, one who presented as a mild delirium and aphasia that resolved without intervention, and one who presented with delirium, seizures, and respiratory insufficiency requiring intensive treatment. The current literature on the treatment and proposed mechanisms of this clinically challenging chimeric antigen receptor T-cell complication is also presented.