PT  - JOURNAL ARTICLE
AU  - Lorna Neill
AU  - Jeremy Rees
AU  - Claire Roddie
TI  - Neurotoxicity—CAR T-cell therapy: what the neurologist needs to know
AID  - 10.1136/practneurol-2020-002550
DP  - 2020 Aug 01
TA  - Practical Neurology
PG  - 285--293
VI  - 20
IP  - 4
4099  - http://pn.bmj.com/content/20/4/285.short
4100  - http://pn.bmj.com/content/20/4/285.full
SO  - Pract Neurol2020 Aug 01; 20
AB  - Chimeric antigen receptor (CAR) T-cell therapy is one of the most innovative therapies for haematological malignancies to emerge in a generation. Clinical studies have shown that a single dose of CAR T-cells can deliver durable clinical remissions for some patients with B-cell cancers where conventional therapies have failed.A significant complication of CAR therapy is the immune effector cell-associated neurotoxicity syndrome (ICANS). This syndrome presents a continuum from mild tremor to cerebral oedema and in a minority of cases, death. Management of ICANS is mainly supportive, with a focus on seizure prevention and attenuation of the immune system, often using corticosteroids. Parallel investigation to exclude other central nervous system pathologies (infection, disease progression) is critical. In this review, we discuss current paradigms around CAR T-cell therapy, with a focus on appropriate investigation and management of ICANS.