Early and Late Toxicities of Chimeric Antigen Receptor T-Cells

Hematol Oncol Clin North Am. 2023 Dec;37(6):1169-1188. doi: 10.1016/j.hoc.2023.05.010. Epub 2023 Jun 21.

Abstract

As chimeric antigen receptor (CAR) T-cell therapy is increasingly integrated into clinical practice across a range of malignancies, identifying and treating inflammatory toxicities will be vital to success. Early experiences with CD19-targeted CAR T-cell therapy identified cytokine release syndrome and neurotoxicity as key acute toxicities and led to unified initiatives to mitigate the influence of these complications. In this section, we provide an update on the current state of CAR T-cell-related toxicities, with an emphasis on emerging acute toxicities affecting additional organ systems and considerations for delayed toxicities and late effects.

Keywords: Bone marrow dysfunction; Chimeric antigen receptor T-cells; Cytokine release syndrome; Cytopenia; Immune effector cell-associated neurotoxicity syndrome; Infectious complications.

Publication types

  • Review
  • Research Support, N.I.H., Intramural

MeSH terms

  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Neoplasms* / drug therapy
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Chimeric Antigen* / genetics
  • T-Lymphocytes

Substances

  • Receptors, Chimeric Antigen
  • Receptors, Antigen, T-Cell