Autonomic dysfunction as manifestation of ICANS: A case report

[Rationale]: Anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy is a successful treatment for B-cell malignancies associated with cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Cardiovascular toxicities have also been reported in this sett...

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Autores: Rochate, Dina, González-García, Antonio Manuel, Marcos Santos, Carmen, Pérez-López, Estefanía, Martín López, Ana África, Alaña, Mónica, Martín-Martín, Lourdes, López-Parra, Miriam, Sánchez-Guijo, Fermín M., López-Corral, Lucía
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/387555
Acceso en línea:http://hdl.handle.net/10261/387555
Access Level:acceso abierto
Palabra clave:Chimeric antigen receptor T cells-dysautonomia
Diffuse large B-cell lymphoma
ICANS
Neurotoxicity
Tachycardia
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spelling Autonomic dysfunction as manifestation of ICANS: A case reportRochate, DinaGonzález-García, Antonio ManuelMarcos Santos, CarmenPérez-López, EstefaníaMartín López, Ana ÁfricaAlaña, MónicaMartín-Martín, LourdesLópez-Parra, MiriamSánchez-Guijo, Fermín M.López-Corral, LucíaChimeric antigen receptor T cells-dysautonomiaDiffuse large B-cell lymphomaICANSNeurotoxicityTachycardia[Rationale]: Anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy is a successful treatment for B-cell malignancies associated with cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Cardiovascular toxicities have also been reported in this setting. However, there is scarce data regarding development of autonomic disorders after CAR-T cell therapy.[Patient concerns]: We report a case with a patient with non-Hodgkin B-cell lymphoma, refractory to 2 prior lines of immunochemotherapy, treated with CAR-T therapy.[Diagnoses]: Orthostatic hypotension secondary to autonomic dysfunction was diagnosed as manifestation of ICANS.[Interventions]: The patient received metilprednisolone 1000 mg IV daily for 3 days and anakinra 100 mg IV every 6h.[Outcomes]: The vast majority of autonomic symptoms ceased and 4 months after CAR-T therapy, autonomic dysfunction was resolved.[Lessons]: New-onset autonomic dysfunction can occur as manifestation of ICANS in patients who experience persistent neurologic and cardiovascular symptoms after resolution of acute neurotoxicity and should be early recognized. Differences in differential diagnosis, mechanisms and treatment approaches are discussed.Peer reviewedLippincott Williams & WilkinsConsejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]202520252024info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://hdl.handle.net/10261/387555reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Ingléshttp://dx.doi.org/10.1097/MD.0000000000038659Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/3875552026-05-22T06:33:51Z
dc.title.none.fl_str_mv Autonomic dysfunction as manifestation of ICANS: A case report
title Autonomic dysfunction as manifestation of ICANS: A case report
spellingShingle Autonomic dysfunction as manifestation of ICANS: A case report
Rochate, Dina
Chimeric antigen receptor T cells-dysautonomia
Diffuse large B-cell lymphoma
ICANS
Neurotoxicity
Tachycardia
title_short Autonomic dysfunction as manifestation of ICANS: A case report
title_full Autonomic dysfunction as manifestation of ICANS: A case report
title_fullStr Autonomic dysfunction as manifestation of ICANS: A case report
title_full_unstemmed Autonomic dysfunction as manifestation of ICANS: A case report
title_sort Autonomic dysfunction as manifestation of ICANS: A case report
dc.creator.none.fl_str_mv Rochate, Dina
González-García, Antonio Manuel
Marcos Santos, Carmen
Pérez-López, Estefanía
Martín López, Ana África
Alaña, Mónica
Martín-Martín, Lourdes
López-Parra, Miriam
Sánchez-Guijo, Fermín M.
López-Corral, Lucía
author Rochate, Dina
author_facet Rochate, Dina
González-García, Antonio Manuel
Marcos Santos, Carmen
Pérez-López, Estefanía
Martín López, Ana África
Alaña, Mónica
Martín-Martín, Lourdes
López-Parra, Miriam
Sánchez-Guijo, Fermín M.
López-Corral, Lucía
author_role author
author2 González-García, Antonio Manuel
Marcos Santos, Carmen
Pérez-López, Estefanía
Martín López, Ana África
Alaña, Mónica
Martín-Martín, Lourdes
López-Parra, Miriam
Sánchez-Guijo, Fermín M.
López-Corral, Lucía
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv Chimeric antigen receptor T cells-dysautonomia
Diffuse large B-cell lymphoma
ICANS
Neurotoxicity
Tachycardia
topic Chimeric antigen receptor T cells-dysautonomia
Diffuse large B-cell lymphoma
ICANS
Neurotoxicity
Tachycardia
description [Rationale]: Anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy is a successful treatment for B-cell malignancies associated with cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Cardiovascular toxicities have also been reported in this setting. However, there is scarce data regarding development of autonomic disorders after CAR-T cell therapy.
publishDate 2024
dc.date.none.fl_str_mv 2024
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/387555
url http://hdl.handle.net/10261/387555
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv http://dx.doi.org/10.1097/MD.0000000000038659
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Lippincott Williams & Wilkins
publisher.none.fl_str_mv Lippincott Williams & Wilkins
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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