Toxicities, intensive care management, and outcome of chimeric antigen receptor T cells in adults: an update
Background Chimeric antigen receptor T cells are a promising new immunotherapy for haematological malignancies. Six CAR-T cells products are currently available for adult patients with refractory or relapsed high-grade B cell malignancies, but they are associated with severe life-threatening toxicities and side effects that may require admission to ICU. Objective The aim of this short pragmatic review is to synthesize for intensivists the knowledge on CAR-T cell therapy with emphasis on CAR-T cell-induced toxicities and ICU management of complications according to international recommendations, outcomes and future issues. Graphical abstract.
Key points Question: What is the role of intensive care in the field of indications, toxicities management, and outcomes after CAR-T cell therapy.Findings: CAR-T cell therapies are developing rapidly and have an increasingly wide range of indications in haematological malignancies, as well as potential for treating solid cancers and autoimmune diseases in the near future. Despite improved survival rates, many patients present severe life-threatening toxicities that may require intensive care management, including cytokine release syndrome, immune effector cells associated neurotoxicity syndromes, immune effector cells associated haemophagocytic lymphohistiocytosis-like syndrome, infections, cardiovascular and renal specific toxicities.Meaning: This short pragmatic update reports the main toxicities after CAR-T cell therapy, the main retrospective observational studies of patients admitted to the ICU for early complications, and a summary of international recommendations for current practice in the medical intensive care unit..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
Critical care - 28(2024), 1 vom: 05. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bellal, Mathieu [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| Themen: |
CAR-T cell therapy |
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| Anmerkungen: |
© The Author(s) 2024 |
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| doi: |
10.1186/s13054-024-04851-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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SPR05503537X |
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| 245 | 1 | 0 | |a Toxicities, intensive care management, and outcome of chimeric antigen receptor T cells in adults: an update |
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| 520 | |a Background Chimeric antigen receptor T cells are a promising new immunotherapy for haematological malignancies. Six CAR-T cells products are currently available for adult patients with refractory or relapsed high-grade B cell malignancies, but they are associated with severe life-threatening toxicities and side effects that may require admission to ICU. Objective The aim of this short pragmatic review is to synthesize for intensivists the knowledge on CAR-T cell therapy with emphasis on CAR-T cell-induced toxicities and ICU management of complications according to international recommendations, outcomes and future issues. Graphical abstract | ||
| 520 | |a Key points Question: What is the role of intensive care in the field of indications, toxicities management, and outcomes after CAR-T cell therapy.Findings: CAR-T cell therapies are developing rapidly and have an increasingly wide range of indications in haematological malignancies, as well as potential for treating solid cancers and autoimmune diseases in the near future. Despite improved survival rates, many patients present severe life-threatening toxicities that may require intensive care management, including cytokine release syndrome, immune effector cells associated neurotoxicity syndromes, immune effector cells associated haemophagocytic lymphohistiocytosis-like syndrome, infections, cardiovascular and renal specific toxicities.Meaning: This short pragmatic update reports the main toxicities after CAR-T cell therapy, the main retrospective observational studies of patients admitted to the ICU for early complications, and a summary of international recommendations for current practice in the medical intensive care unit. | ||
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