CAR-T cell: Toxicities issues: Mechanisms and clinical management.
Adrenal Cortex Hormones
/ therapeutic use
Agammaglobulinemia
/ etiology
Antibodies, Monoclonal, Humanized
/ therapeutic use
Biomarkers
/ analysis
Cytokine Release Syndrome
/ diagnosis
Humans
Immunotherapy, Adoptive
/ adverse effects
Infections
/ etiology
Neurotoxicity Syndromes
/ diagnosis
Receptors, Chimeric Antigen
/ immunology
Risk Factors
T-Lymphocytes
/ immunology
Chimeric antigen receptor
Cytokine release syndrome
T-cell therapy
Journal
Bulletin du cancer
ISSN: 1769-6917
Titre abrégé: Bull Cancer
Pays: France
ID NLM: 0072416
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
30
03
2021
revised:
17
05
2021
accepted:
21
05
2021
entrez:
18
12
2021
pubmed:
19
12
2021
medline:
30
12
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 34920794
pii: S0007-4551(21)00248-4
doi: 10.1016/j.bulcan.2021.05.003
pii:
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Antibodies, Monoclonal, Humanized
0
Biomarkers
0
Receptors, Chimeric Antigen
0
tocilizumab
I031V2H011
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
S117-S127Informations de copyright
Copyright © 2021 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.