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Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?

The Cornell Assessment for Pediatric Delirium (CAPD) was first proposed by the Pediatric Acute Lung Injury and Sepsis Investigators Network-Stem Cell Transplantation and Cancer Immunotherapy Subgroup and MD Anderson CARTOX joint working committees, for detection of immune effector cell associated ne...

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Autores principales: Brown, Brandon Douglas, Tambaro, Francesco Paolo, Kohorst, Mira, Chi, Linda, Mahadeo, Kris Michael, Tewari, Priti, Petropoulos, Demetrios, Slopis, John M., Sadighi, Zsila, Khazal, Sajad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982581/
https://www.ncbi.nlm.nih.gov/pubmed/33763368
http://dx.doi.org/10.3389/fonc.2021.634445
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author Brown, Brandon Douglas
Tambaro, Francesco Paolo
Kohorst, Mira
Chi, Linda
Mahadeo, Kris Michael
Tewari, Priti
Petropoulos, Demetrios
Slopis, John M.
Sadighi, Zsila
Khazal, Sajad
author_facet Brown, Brandon Douglas
Tambaro, Francesco Paolo
Kohorst, Mira
Chi, Linda
Mahadeo, Kris Michael
Tewari, Priti
Petropoulos, Demetrios
Slopis, John M.
Sadighi, Zsila
Khazal, Sajad
author_sort Brown, Brandon Douglas
collection PubMed
description The Cornell Assessment for Pediatric Delirium (CAPD) was first proposed by the Pediatric Acute Lung Injury and Sepsis Investigators Network-Stem Cell Transplantation and Cancer Immunotherapy Subgroup and MD Anderson CARTOX joint working committees, for detection of immune effector cell associated neurotoxicity (ICANS) in pediatric patients receiving chimeric antigen receptor (CAR) T-cell therapy. It was subsequently adopted by the American Society for Transplantation and Cellular Therapy. The utility of CAPD as a screening tool for early diagnosis of ICANS has not been fully characterized. We conducted a retrospective study of pediatric and young adult patients (n=15) receiving standard-of-care CAR T-cell products. Cytokine release syndrome (CRS) and ICANS occurred in 87% and 40% of patients, respectively. ICANS was associated with significantly higher peaks of serum ferritin. A change in CAPD from a prior baseline was noted in 60% of patients with ICANS, 24–72 h prior to diagnosis of ICANS. The median change from baseline to maximum CAPD score of patients who developed ICANS versus those who did not was 13 versus 3, respectively (p=0.0004). Changes in CAPD score from baseline may be the earliest indicator of ICANS among pediatric and young adult patients which may warrant closer monitoring, with more frequent CAPD assessments.
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spelling pubmed-79825812021-03-23 Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis? Brown, Brandon Douglas Tambaro, Francesco Paolo Kohorst, Mira Chi, Linda Mahadeo, Kris Michael Tewari, Priti Petropoulos, Demetrios Slopis, John M. Sadighi, Zsila Khazal, Sajad Front Oncol Oncology The Cornell Assessment for Pediatric Delirium (CAPD) was first proposed by the Pediatric Acute Lung Injury and Sepsis Investigators Network-Stem Cell Transplantation and Cancer Immunotherapy Subgroup and MD Anderson CARTOX joint working committees, for detection of immune effector cell associated neurotoxicity (ICANS) in pediatric patients receiving chimeric antigen receptor (CAR) T-cell therapy. It was subsequently adopted by the American Society for Transplantation and Cellular Therapy. The utility of CAPD as a screening tool for early diagnosis of ICANS has not been fully characterized. We conducted a retrospective study of pediatric and young adult patients (n=15) receiving standard-of-care CAR T-cell products. Cytokine release syndrome (CRS) and ICANS occurred in 87% and 40% of patients, respectively. ICANS was associated with significantly higher peaks of serum ferritin. A change in CAPD from a prior baseline was noted in 60% of patients with ICANS, 24–72 h prior to diagnosis of ICANS. The median change from baseline to maximum CAPD score of patients who developed ICANS versus those who did not was 13 versus 3, respectively (p=0.0004). Changes in CAPD score from baseline may be the earliest indicator of ICANS among pediatric and young adult patients which may warrant closer monitoring, with more frequent CAPD assessments. Frontiers Media S.A. 2021-03-08 /pmc/articles/PMC7982581/ /pubmed/33763368 http://dx.doi.org/10.3389/fonc.2021.634445 Text en Copyright © 2021 Brown, Tambaro, Kohorst, Chi, Mahadeo, Tewari, Petropoulos, Slopis, Sadighi and Khazal http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Brown, Brandon Douglas
Tambaro, Francesco Paolo
Kohorst, Mira
Chi, Linda
Mahadeo, Kris Michael
Tewari, Priti
Petropoulos, Demetrios
Slopis, John M.
Sadighi, Zsila
Khazal, Sajad
Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?
title Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?
title_full Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?
title_fullStr Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?
title_full_unstemmed Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?
title_short Immune Effector Cell Associated Neurotoxicity (ICANS) in Pediatric and Young Adult Patients Following Chimeric Antigen Receptor (CAR) T-Cell Therapy: Can We Optimize Early Diagnosis?
title_sort immune effector cell associated neurotoxicity (icans) in pediatric and young adult patients following chimeric antigen receptor (car) t-cell therapy: can we optimize early diagnosis?
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982581/
https://www.ncbi.nlm.nih.gov/pubmed/33763368
http://dx.doi.org/10.3389/fonc.2021.634445
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