Immune effector cell-associated neurotoxicity syndrome (ICANS)

Immune effector cell-associated neurotoxicity syndrome after chimeric antigen receptor T-cell therapy for large B cell lymphoma.

56% patients develop ICANS.

 ICANS. Median time to development of ICANS was 5 days (range, 3-11). 

Elevated pre-infusion fibrinogen and lactate dehydrogenase are associated with ICANS. 

A larger drop in fibrinogen was associated with ICANS.

Development of ICANS of any grade had no effect on complete remission (CR), progression-free survival (PFS), or overall survival (OS). 

Duration and total dose of steroid treatment administered for ICANS did not influence CR, PFS, or OS.

Immune effector cell-associated neurotoxicity syndrome (ICANS) is a rare and potentially life-threatening side effect that can occur in cancer patients who receive CAR T-cell therapy or other forms of immunotherapy. 

ICANS is caused by an excessive inflammatory response triggered by the infused immune cells, which can cause swelling and inflammation in the brain and nervous system.

Symptoms of ICANS can range from mild confusion and headaches to seizures, hallucinations and even coma. 

The severity of the syndrome can vary depending on the patient and the type of cancer treatment they are receiving.

Treatments may include corticosteroids to reduce inflammation and other supportive care measures as needed. 

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