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Use of long-term corticosteroids in patients treated with CAR T-cell therapy.
- Source :
-
Journal of Oncology Pharmacy Practice . Mar2023, Vol. 29 Issue 2, p473-476. 4p. - Publication Year :
- 2023
-
Abstract
- Introduction: Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are common toxicities associated with chimeric antigen receptor (CAR) T-cell therapy. Severe grade 3 or higher ICANS is less common and requires the use of corticosteroids with or without an Interleukin (IL)-6 receptor antagonist. Although corticosteroids are effective in the management of CRS and ICANS, their impact on CAR T efficacy remains unknown. Case report: We present the case of a 65-year-old male who received CAR T-cell therapy with brexucabtagene autoleucel for stage I/II Mantle Cell Lymphoma (MCL) and achieved complete remission despite receiving a prolonged course of corticosteroids for severe ICANS. Management and outcome: The patient received treatment with high-dose corticosteroids, tocilizumab, and anakinra, in addition to multiple antiepileptic agents. Despite a remitting relapsing pattern of ICANS, the patient not only recovered from the life-threatening complication but also achieved a complete remission at three months post CAR T. Conclusion: This case describes the successful use of corticosteroids for the management of ICANS in a patient treated with CAR T-cell therapy for MCL. [ABSTRACT FROM AUTHOR]
- Subjects :
- *THERAPEUTIC use of antineoplastic agents
*NEUROTOXICOLOGY
*ANTICONVULSANTS
*ADRENOCORTICAL hormones
*SYNDROMES
*COMBINATION drug therapy
*TOCILIZUMAB
*CELL receptors
*POSITRON emission tomography computed tomography
*DIFFERENTIAL diagnosis
*TUMOR classification
*TREATMENT effectiveness
*CYTOKINE release syndrome
*DISEASE relapse
*CATASTROPHIC illness
*T cells
*NON-Hodgkin's lymphoma
*IMMUNOTHERAPY
*DISEASE remission
Subjects
Details
- Language :
- English
- ISSN :
- 10781552
- Volume :
- 29
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Journal of Oncology Pharmacy Practice
- Publication Type :
- Academic Journal
- Accession number :
- 161686428
- Full Text :
- https://doi.org/10.1177/10781552221104816