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Optimization Strategies in CAR T-cell Therapy: A Comprehensive Evaluation of Cytopenia, HLH/MAS, and Other Adverse Events.
Qureshi, Zaheer; Altaf, Faryal; Jamil, Abdur; Siddique, Rimsha.
Affiliation
  • Qureshi Z; Department of Medicine, The Frank H. Netter MD School of Medicine at Quinnipiac University, Bridgeport, CT.
  • Altaf F; Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/BronxCare Health System, New York.
  • Jamil A; Department of Medicine, Samaritan Medical Centre.
  • Siddique R; Independent Research Associate, Watertown, NY.
Am J Clin Oncol ; 2024 Jun 21.
Article in En | MEDLINE | ID: mdl-38907604
ABSTRACT
Chimeric antigen receptor (CAR) T-cell therapy has emerged as a transformative treatment for various hematological malignancies. Still, its remarkable efficacy is accompanied by unique adverse events that must be carefully managed. This comprehensive literature review evaluates the safety profile of CAR T-cell therapy, focusing on cytopenia, hemophagocytic lymphohistiocytosis (HLH)/macrophage activation syndrome (MAS), and other potential complications. Cytopenia, characterized by reduced blood cell counts, affects a significant proportion of patients, with rates of anemia, neutropenia, and thrombocytopenia reaching up to 60%, 70%, and 80%, respectively. Risk factors include high tumor burden, prior chemotherapy, and bone marrow involvement. Cytokine release syndrome (CRS) occurs in 13% to 77% of patients and is linked to the cytokine storm induced by CAR T cells, target antigen expression, and preexisting immune dysregulation. Other notable adverse events discussed are cytokine release syndrome, neurotoxicity, and infections. Understanding the mechanisms, risk factors, and management strategies for these adverse events is crucial for optimizing patient outcomes and unlocking the full potential of this revolutionary therapy. The review highlights the need for continued research, interdisciplinary collaboration, and evidence-based approaches to enhance the safety and efficacy of CAR T-cell therapy.

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Am J Clin Oncol Year: 2024 Document type: Article Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Am J Clin Oncol Year: 2024 Document type: Article Country of publication: United States