Neurological Complications of CAR T Cell Therapy

Abstract

Purpose of review: Chimeric antigen receptor (CAR) T cells are a breakthrough therapeutic treatment for patients with relapsed and refractory hematologic malignancies. With two FDA-approved formulations and likely more to come, CAR T cell therapy is moving beyond clinical trials and into academic and community oncology practices throughout the country. Oncologists are tasked with understanding the indications for this treatment and the potential complications.

Recent findings: In this review, we focus on the neurological toxicities associated with CAR T cell therapy. Neurotoxicity affects approximately half of patients treated with CAR T cells and can cause severe morbidity. We discuss the incidence, pathophysiology, and management of neurological complications of CAR T cells. CAR T cells are a breakthrough treatment for hematologic malignancies with considerable neurological toxicity that requires attention and management.

Keywords: CAR T cell therapy; Chimeric antigen receptor; Immune effector cell-associated neurotoxicity syndrome; Neurotoxicity.