Vonberg Frederick W, Malik Imran, O'Reilly Maeve, Hyare Harpreet, Carr Aisling S, Roddie Claire
National Hospital for Neurology and Neurosurgery, London, UK
UCL Queen Square Institute of Neurology, London, UK.
J Neurol Neurosurg Psychiatry. 2025 Jun 12;96(7):665-678. doi: 10.1136/jnnp-2024-333924.
Chimeric antigen receptor (CAR) T-cell therapy has revolutionised the treatment of haematological malignancies and has demonstrated efficacy in early trials for solid tumours, neurological and rheumatological autoimmune diseases. However, CAR-T is complicated in some patients by neurotoxicity syndromes including immune-effector cell-associated neurotoxicity syndrome, and the more recently described movement and neurocognitive treatment-emergent adverse events, and tumour inflammation-associated neurotoxicity. These neurotoxic syndromes remain poorly understood and are associated with significant morbidity and mortality. A multidisciplinary approach, including neurologists, haematologists and oncologists, is critical for the diagnosis and management of CAR-T neurotoxicity. This approach will be of increasing importance as the use of CAR-T expands, its applications increase and as novel neurotoxic syndromes emerge.
嵌合抗原受体（CAR）T细胞疗法彻底改变了血液系统恶性肿瘤的治疗方式，并在实体瘤、神经和风湿性自身免疫性疾病的早期试验中显示出疗效。然而，CAR-T在一些患者中会引发神经毒性综合征，包括免疫效应细胞相关神经毒性综合征，以及最近描述的运动和神经认知治疗中出现的不良事件，还有肿瘤炎症相关神经毒性。这些神经毒性综合征仍未得到充分了解，且与显著的发病率和死亡率相关。包括神经科医生、血液科医生和肿瘤科医生在内的多学科方法对于CAR-T神经毒性的诊断和管理至关重要。随着CAR-T的使用范围扩大、应用增加以及新的神经毒性综合征出现，这种方法将变得越来越重要。
