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EEG before chimeric antigen receptor T-cell therapy and early after onset of immune effector cell-associated neurotoxicity syndrome.
Hernani, Rafael; Aiko, Mika; Victorio, Ruth; Benzaquén, Ana; Pérez, Ariadna; Piñana, José Luis; Hernández-Boluda, Juan Carlos; Amat, Paula; Pastor-Galán, Irene; Remigia, María José; Ferrer-Lores, Blanca; Micó, Mireia; Carbonell, Nieves; Ferreres, José; Blasco-Cortés, María Luisa; Santonja, José Miguel; Dosdá, Rosa; Estellés, Rocío; Campos, Salvador; Martínez-Ciarpaglini, Carolina; Ferrández-Izquierdo, Antonio; Goterris, Rosa; Gómez, Montse; Teruel, Anabel; Saus, Ana; Ortiz, Alfonso; Morello, Daniela; Martí, Edel; Carretero, Carlos; Calabuig, Marisa; Tormo, Mar; Terol, María José; Cases, Paula; Solano, Carlos.
Afiliación
  • Hernani R; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain. Electronic address: hernani_raf@gva.es.
  • Aiko M; Neurophysiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Victorio R; Neurophysiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Benzaquén A; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Pérez A; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Piñana JL; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Hernández-Boluda JC; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.
  • Amat P; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.
  • Pastor-Galán I; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Remigia MJ; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Ferrer-Lores B; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Micó M; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Carbonell N; Intensive Care Unit, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Ferreres J; Intensive Care Unit, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Blasco-Cortés ML; Intensive Care Unit, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Santonja JM; Neurology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Dosdá R; Radiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Estellés R; Radiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Campos S; Radiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Martínez-Ciarpaglini C; Pathology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Ferrández-Izquierdo A; Pathology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Goterris R; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Gómez M; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Teruel A; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.
  • Saus A; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Ortiz A; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Morello D; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Martí E; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Carretero C; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Calabuig M; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Tormo M; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.
  • Terol MJ; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.
  • Cases P; Neurophysiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
  • Solano C; Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.
Clin Neurophysiol ; 163: 132-142, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38733703
ABSTRACT

BACKGROUND:

Immune effector cell-associated neurotoxicity syndrome (ICANS) is common after chimeric antigen receptor T-cell (CAR-T) therapy.

OBJECTIVE:

This study aimed to assess the impact of preinfusion electroencephalography (EEG) abnormalities and EEG findings at ICANS onset for predicting ICANS risk and severity in 56 adult patients with refractory lymphoma undergoing CAR-T therapy. STUDY

DESIGN:

EEGs were conducted at the time of lymphodepleting chemotherapy and shortly after onset of ICANS.

RESULTS:

Twenty-eight (50%) patients developed ICANS at a median time of 6 days after CAR-T infusion. Abnormal preinfusion EEG was identified as a risk factor for severe ICANS (50% vs. 17%, P = 0.036). Following ICANS onset, EEG abnormalities were detected in 89% of patients [encephalopathy (n = 19, 70%) and/or interictal epileptiform discharges (IEDs) (n = 14, 52%)]. Importantly, IEDs seemed to be associated with rapid progression to higher grades of ICANS within 24 h.

CONCLUSIONS:

If confirmed in a large cohort of patients, these findings could establish the basis for modifying current management guidelines, enabling the identification of patients at risk of neurotoxicity, and providing support for preemptive corticosteroid use in patients with both initial grade 1 ICANS and IEDs at neurotoxicity onset, who are at risk of neurological impairment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inmunoterapia Adoptiva / Síndromes de Neurotoxicidad / Electroencefalografía Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inmunoterapia Adoptiva / Síndromes de Neurotoxicidad / Electroencefalografía Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos