Neuroimaging findings in immune effector cell associated neurotoxicity syndrome after chimeric antigen receptor T-cell therapy. Issue 10 (24th August 2022)

• Record Type: Journal Article
• Authors: Lapidus, Adam H.; Anderson, Mary Ann; Harrison, Simon J.; Dickinson, Michael; Kalincik, Tomas; Lasocki, Arian
• Is Part Of: Leukemia & lymphoma. Volume 63:Issue 10(2022)
• Page Start: 2364
• Page End: 2374
• Publication Date: 2022-08-24
• Subjects: Chimeric antigen receptor T-cell therapy -- hematological malignancies -- immune effector cell associated neurotoxicity syndrome -- neuroimaging -- magnetic resonance imaging; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2022.2074990
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Chimeric antigen receptor T-cell (CAR-T) therapy is a promising immunotherapy approved for hematological malignancies. Despite its effectiveness, clinically significant rates of toxicity, including immune effector cell associated neurotoxicity syndrome (ICANS), limit its widespread use. In certain contexts, ICANS may occur in up to one-third of patients using commercially available CAR-T therapies. The syndrome presents with a range of neurological signs and symptoms, as well as a variety of neuroimaging manifestations reported in the literature. A systematic review of the literature was performed. The systematic search strategy identified 24 studies discussing the neuroimaging appearances associated with ICANS. Imaging findings are more common in patients with higher grade neurotoxicity. The neuroimaging findings are heterogeneous, but can be grouped either anatomically (white matter, gray matter, brainstem, or leptomeninges) or pathologically (ischemic changes, hemorrhages, or cerebral edema). An understanding of the imaging manifestations of ICANS has the potential to impact the management of patients.