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.

中文翻译：

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神经毒性——CAR T 细胞疗法：神经科医生需要知道什么

嵌合抗原受体 (CAR) T 细胞疗法是一代人出现的血液系统恶性肿瘤最具创新性的疗法之一。临床研究表明，单剂量的 CAR T 细胞可以为一些传统疗法失败的 B 细胞癌患者带来持久的临床缓解。CAR 治疗的一个重要并发症是免疫效应细胞相关神经毒性综合征 (ICANS)。这种综合征表现为从轻度震颤到脑水肿的连续过程，在少数情况下会导致死亡。ICANS 的管理主要是支持性的，重点是癫痫发作的预防和免疫系统的减弱，通常使用皮质类固醇。排除其他中枢神经系统病理（感染、疾病进展）的平行调查至关重要。在这次审查中，