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. 2023 Nov:140:103126.
doi: 10.1016/j.jaut.2023.103126. Epub 2023 Oct 12.

Cognition following chimeric antigen receptor T-cell therapy: A systematic review

Christina Kazzi  1 , Valeriya Kuznetsova  2 , Pakeeran Siriratnam  1 , Sarah Griffith  1 , Shu Wong  3 , Constantine S Tam  4 , Rubina Alpitsis  1 , Andrew Spencer  5 , Terence J O'Brien  1 , Charles B Malpas  6 , Mastura Monif  7
Affiliations
Free article

Cognition following chimeric antigen receptor T-cell therapy: A systematic review

Christina Kazzi et al. J Autoimmun. 2023 Nov.
Free article

Abstract

Background: This systematic review aimed to characterise the cognitive outcomes of patients who received chimeric antigen receptor T-cell therapy.

Methods: A systematic search of the literature was performed using PubMed, PsycINFO, SCOPUS, EMBASE, Medline, and CINAHL (February 2023). Risk of bias was assessed using the JBI Checklist for Case Reports and the Risk of Bias Assessment Tool for Non-randomised Studies.

Results: Twenty-two studies met inclusion criteria with a total of 1104 participants. There was considerable methodological heterogeneity with differing study designs (e.g., cohort studies, clinical trials, case studies, a qualitative interview, and a focus group), measures of cognition (e.g., self-report, neuropsychological measures, clinician assessed/neurological examinations), and longest follow-up time points (i.e., five days to five years).

Discussion: Results of the studies were heterogenous with studies demonstrating stable, improved, or reduced cognition across differing time points. Overall, cognitive symptoms are common particularly in the acute stage (<2 weeks) post-infusion. Most deficits that arise in the acute stage resolve within one to two weeks, however, there is a subset of patients who continue to experience and self-report persistent deficits in the subacute and chronic stages. Future studies are needed to comprehensively analyse cognition using a combination of self-report and psychometric measures following chimeric antigen receptor T-cell therapy in the acute, subacute, and chronic settings.

Keywords: Chimeric antigen receptor T-cell therapy; Cognition; Haematological cancer; Neurotoxicity.

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Conflict of interest statement

Declaration of competing interest TO has received support from the National Health and Medical Research Council, The National Institute of Neurological Disorders and Stroke and Monash University. He has been supported by research grants and consultancies to his institution from Eisai, UCB Pharma, Praxis Precision Medicines, BioGen and Supernus. CM has received conference travel support and/or speaker fees from Merck, Novartis, and Biogen. He has received research support from the National Health and Medical Research Council, Multiple Sclerosis Research Australia, The University of Melbourne, The Royal Melbourne Hospital Neuroscience Foundation, and Dementia Australia. MM has served on advisory board for Merck, has received speaker honoraria from Merck, Biogen and Novartis. Her institution receives funding from Merck, Australian National Health Medical Research Council, Brain Foundation, Charles and Sylvia Viertel Foundation, and MS Research Australia. RA and CK have no conflicts of interest to declare.

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