Department of Neuro-Oncology, Columbia University, New York, NY 10033 USA.
Department of Neurology, The University of Chicago Medical Center, Chicago, IL 60637, USA.
Immunotherapy. 2021 Oct;13(15):1261-1269. doi: 10.2217/imt-2021-0084. Epub 2021 Sep 24.
Neurotoxicity (NT) is a common complication of chimeric antigen receptor (CAR) T-cell therapy. Data on early clinical identifiers for impending severe NT are lacking. The authors performed a retrospective study on 26 adult relapsed/refractory diffuse large B cell lymphoma patients treated with commercial CAR T-cell therapy (December 2017 - September 2018). NT of any grade and severe NT occurred in 88 and 31% of patients, respectively. Dysgraphia (p < 0.01), disorientation (p = 0.01) and inattention (p = 0.018) were associated with severe NT, with positive predictive values of 100, 87.5 and 87.5%, respectively. Dysnomia was not associated with severe NT. In the authors' limited cohort, the dysgraphia, disorientation and inattention components of the CAR T-cell therapy-associated toxicity 10 scoring system were significantly associated with and predictive of impending severe NT.
神经毒性（NT）是嵌合抗原受体（CAR）T 细胞疗法的常见并发症。关于即将发生严重 NT 的早期临床指标的数据尚缺乏。作者对 26 例接受商业 CAR T 细胞疗法治疗的复发性/难治性弥漫性大 B 细胞淋巴瘤成年患者进行了回顾性研究（2017 年 12 月-2018 年 9 月）。任何级别和严重程度的 NT 分别发生在 88%和 31%的患者中。构音障碍（p<0.01）、定向障碍（p=0.01）和注意力不集中（p=0.018）与严重 NT 相关，其阳性预测值分别为 100%、87.5%和 87.5%。构音障碍与严重 NT 无相关性。在作者的有限队列中，CAR T 细胞疗法相关毒性 10 评分系统的构音障碍、定向障碍和注意力不集中成分与严重 NT 密切相关，且具有预测性。
