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MINI REVIEW article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1396490
This article is part of the Research Topic Transplantation and Cellular Therapy in Lymphomas and Plasma Cell Disorders View all 8 articles

Mechanisms and Management of CAR T Toxicity

Provisionally accepted
Christopher J. Ferreri Christopher J. Ferreri Manisha Bhutani Manisha Bhutani *
  • Levine Cancer Institute, Charlotte, United States

The final, formatted version of the article will be published soon.

    Chimeric antigen receptor (CAR) T cell therapies have dramatically improved treatment outcomes for patients with relapsed or refractory B-cell acute lymphoblastic leukemia, large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, and multiple myeloma. Despite unprecedented efficacy, treatment with CAR T cell therapies can cause a multitude of adverse effects which require monitoring and management at specialized centers and contribute to morbidity and non-relapse mortality. Such toxicities include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, neurotoxicity distinct from ICANS, immune effector cell-associated hemophagocytic lymphohistiocytosislike syndrome, and immune effector cell-associated hematotoxicity that can lead to prolonged cytopenias and infectious complications. This review will discuss the current understanding of the underlying pathophysiologic mechanisms and provide guidelines for the grading and management of such toxicities.

    Keywords: Chimeric antigen receptor (CAR T), Cytokine Release Syndrom (CRS), ICANS - immune effector cell-associated neurotoxicity syndrome, HLH - hemophagocytic lymphohistiocytosis, tocilizumab (IL-6 inhibitor), Large B cell lymphoma, Multiple Myeloma

    Received: 05 Mar 2024; Accepted: 07 May 2024.

    Copyright: © 2024 Ferreri and Bhutani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Manisha Bhutani, Levine Cancer Institute, Charlotte, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.