Vorozheikina, E.; Ruiz, M.; Solari, M.L.; Ostasevich, D.; Mendoza, L. Overview of Adverse Events Associated With Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy. Preprints2021, 2021040517. https://doi.org/10.20944/preprints202104.0517.v1
APA Style
Vorozheikina, E., Ruiz, M., Solari, M.L., Ostasevich, D., & Mendoza, L. (2021). Overview of Adverse Events Associated With Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy. Preprints. https://doi.org/10.20944/preprints202104.0517.v1
Chicago/Turabian Style
Vorozheikina, E., Dmitry Ostasevich and Luis Mendoza. 2021 "Overview of Adverse Events Associated With Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy" Preprints. https://doi.org/10.20944/preprints202104.0517.v1
Abstract
Anti-CD19 chimeric antigen receptor (CAR) T-cells represent a novel immunotherapy that has shown remarkable success in the treatment of adult relapsed or refractory (R/R) B-cell non-Hodgkin's lymphoma, adult R/R mantle cell lymphoma, and R/R acute paediatric lymphoblastic leukaemia. One barrier to the widespread use of CAR T-cell therapy is toxicity, primarily cytokine release syndrome (CRS) with a variable grade of severity. The main manifestations of CRS are fever, hypotension, cytopenia, organ dysfunction among others. Neurological toxicities vary widely and range from headaches to encephalopathy. In addition, anti-CD19 CAR T-cell therapy provokes an array of less frequent events, such as coagulopathies, delayed cytopenia, and cardiovascular toxicities. In general, toxicities are usually reversible and resolve on their own in most cases, though severe cases may require intensive care and immunosuppressive therapy. Deaths due to CRS, neurologic toxicity and infectious complications have been reported, which highlights the gravity of these syndromes and the critical nature of appropriate intervention. In this paper, we look at all available FDA- and EMA-approved information about the pathophysiology, clinical manifestations, risk factor reviews of existing toxicity grading systems, current management strategies, and guidelines for anti-CD19 CAR T-cell toxicities. We also present new approaches, which are under investigation, to mitigate these adverse events.
Keywords
CAR T-cells; chimeric antigen receptor T cells; cytokine release syndrome; central nervous system toxicity; neurotoxicity; adverse events; pathophysiology
Subject
Medicine and Pharmacology, Oncology and Oncogenics
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
