immune effector cell-associated neurotoxicity syndrome (ICANS)
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Etiology
Pathology
Clinical manifestations
- neurological symptoms may include
- apraxia, expressive aphasia, disorientation, hallucinations[3]
- dysgraphia, confusion, somnolence[4]
Laboratory
Diagnostic procedures
- electroencephalogram (EEG): diffuse slowing (all); focal slowing in 30%[4]
Radiology
Management
- treatment with dexamethasone[3]
- median total dose equivalent to 221 mg of dexamethasone for a median duration of 12.5 days (18 mg/day)[4]
More general terms
References
- ↑ Siegler EL, Kenderian SS Neurotoxicity and Cytokine Release Syndrome After Chimeric Antigen Receptor T Cell Therapy: Insights Into Mechanisms and Novel Therapies. Front Immunol. 2020. Aug 28;11:1973 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32983132 PMCID: PMC7485001 Free PMC article https://www.frontiersin.org/articles/10.3389/fimmu.2020.01973/full
- ↑ Holtzman NG, Xie H, Bentzen S et al Immune effector cell-associated neurotoxicity syndrome after chimeric antigen receptor T-cell therapy for lymphoma: predictive biomarkers and clinical outcomes. Neuro Oncol. 2021 Jan 30;23(1):112-121 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32750704 PMCID: PMC7850044 Free PMC article
- ↑ 3.0 3.1 3.2 3.3 3.4 Mohn N, Bonda V, Grote-Levi L et al Neurological management and work-up of neurotoxicity associated with CAR T cell therapy. Neurol Res Pract. 2022 Jan 10;4(1):1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35000613 PMCID: PMC8744256 Free PMC article
- ↑ 4.0 4.1 4.2 4.3 4.4 Holzman NG et al Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) after CD19-Directed Chimeric Antigen Receptor T-Cell Therapy (CAR-T) for Large B-Cell Lymphoma: Predictive Biomarkers and Clinical Outcomes. Blood. 2019. 134(Suppl 1)3239 https://ashpublications.org/blood/article/134/Supplement_1/3239/423803/Immune-Effector-Cell-Associated-Neurotoxicity