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Review
. 2024 Mar 5;28(1):69.
doi: 10.1186/s13054-024-04851-0.

Toxicities, intensive care management, and outcome of chimeric antigen receptor T cells in adults: an update

Mathieu Bellal  1   2 , Jolan Malherbe  3 , Gandhi Damaj  4 , Damien Du Cheyron  3
Affiliations
Review

Toxicities, intensive care management, and outcome of chimeric antigen receptor T cells in adults: an update

Mathieu Bellal et al. Crit Care. .

Abstract

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.

Keywords: CAR-T cell therapy; Haematological malignancies; Intensive care management; Toxicities.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Five generation of CAR-T (adapted from [2, 3])
Fig. 2
Fig. 2
Antitumour mechanisms of CAR-T and cytokine release results in bystander activation of other immune cells (adapted from [7])
Fig. 3
Fig. 3
Algorithm of management of CRS (A), ICANS (B), IEC-HS (C), and infections (D)
Fig. 4
Fig. 4
CAR-HEMATOTOX: to be determined before lymphodepletion to discriminate between a low and a high risk for haematotoxicity, from [60]
See this image and copyright information in PMC

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