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CAR-T cell: Toxicities issues: Mechanisms and clinical management
- Source :
- Bulletin du Cancer. 108:S117-S127
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- CAR-T cells are modified T cells expressing a chimeric antigen receptor targeting a specific antigen. They have revolutionized the treatment of B cell malignancies (aggressive lymphomas, B-ALL), and this has raised hopes for application in many other pathologies (myeloma, AML, solid tumors, etc.). However, these therapies are associated with novel and specific toxicities (cytokine release syndrome and neurotoxicity). These complications, although mostly managed in a conventional hospitalization unit, can sometimes be life threatening, leading to admission of patients to the intensive care unit. Management relies mainly on anti-IL6R (tocilizumab) and corticosteroids. However, the optimal treatment regimen is still a matter of debate, and the management of the most severe forms is even less well codified. In addition to CRS and ICANS, infections, cytopenia and hypogammaglobulinemia are other frequent complications. This article reviews the mechanisms, risk factors, clinical presentation, and management of these toxicities.
- Subjects :
- Cancer Research
Receptors, Chimeric Antigen
T-Lymphocytes
Hematology
General Medicine
Antibodies, Monoclonal, Humanized
Infections
Immunotherapy, Adoptive
Oncology
Adrenal Cortex Hormones
Agammaglobulinemia
Risk Factors
Humans
Neurotoxicity Syndromes
Radiology, Nuclear Medicine and imaging
Cytokine Release Syndrome
Biomarkers
Subjects
Details
- ISSN :
- 00074551
- Volume :
- 108
- Database :
- OpenAIRE
- Journal :
- Bulletin du Cancer
- Accession number :
- edsair.doi.dedup.....90e39c92f046ebc6319caacf3ab48170