Magnetic resonance imaging (MRI) and lumbar puncture (LP) may not always be necessary for diagnosing and managing a serious neurological complication associated with CAR T-cell therapy, according to a new Blood Advances study.
Mar 19 2024American Society of Hematology Magnetic resonance imaging and lumbar puncture may not always be necessary for diagnosing and managing a serious neurological complication associated with CAR T-cell therapy, according to a new Blood Advances study. Findings further validated the use of the electroencephalogram – a noninvasive test measuring electrical activity in the brain – in managing this neurotoxicity.
Authors sought to evaluate the necessity of three diagnostic tests used to manage care for recipients of CAR T-cell therapy experiencing immune effector cell-associated neurotoxicity syndrome . While ICANS' underlying mechanisms are not entirely understood, patients with ICANS may experience a range of neurological symptoms, including confusion, tremors, seizures, and, in rare cases, serious brain swelling and comas.
All study participants met with a neurologist and underwent an MRI scan as a baseline assessment before receiving CAR T-cell infusions. Among those who experienced ICANS, their treatment protocol depended on their unique case and physician recommendation, abiding by the existing guidelines. Most patients with ICANS underwent at least one intervention, and a third underwent all three .
Results ultimately revealed that abnormal results were more common in patients with more severe ICANS. MRI results were often normal and while LP and EEG often showed abnormalities, it was more frequent with more severe cases of ICANS.
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