European journal of cancer (Oxford, England : 1990) · 2026
Evidence for early, clinically silent medial temporal lobe inflammation after CAR-T cell therapy.
СтатьяНазвание и аннотация: Перевод в очереди
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Dubai Marwa Al, Rebello Mahima Verginia, Neumann Katja, Berisha Mirjeta, Katsaros Dimitrios, Haage Tobias Ronny, Walther Denise, Kaufmann Jörn, Fricke Stephan, Uher Daniel, Speck Oliver, Engel Johanna, Meuth Sven G, Melekh Bohdan, Behme Daniel, Mattern Hendrik, Henneicke Solveig, Schreiber Stefanie, Mougiakakos Dimitrios
Аннотация
OBJECTIVE: Immune effector cell-associated neurotoxicity syndrome (ICANS) is the most frequent neurological complication following chimeric antigen receptor (CAR)-T cell therapy. Long-term cognitive effects remain controversial, even in the absence of clinical neurotoxicity. CAR-T cell-associated neurotoxicity often involves the medial temporal lobe (MTL), yet conventional structural magnetic resonance imaging (MRI) frequently remains normal. There is a need for markers of subclinical neurotoxicity that may predict long-term cognitive outcomes.
METHODS: Therefore, we established an imaging protocol integrating 3 Tesla (T) and 7 T perfusion and functional connectivity MRI of the MTL in patients receiving CAR-T cells for B cell malignancies. Longitudinal data from four patients is presented here.
RESULTS: Two of the four patients developed ICANS (grade 1 and grade 3), and these patients also experienced mild cytokine release syndrome (CRS, grade 1). No structural abnormalities of the MTL were detected at baseline or during follow-up. CAR-T cell expansion varied markedly between patients. Regardless of ICANS, CRS, or CAR-T cell expansion, patients showed increased MTL perfusion and functional connectivity, most prominently at days 10-14.
CONCLUSION: These data suggest an early, clinically silent inflammatory response in the MTL with potential implications for long-term cognitive function, which requires further investigation.
METHODS: Therefore, we established an imaging protocol integrating 3 Tesla (T) and 7 T perfusion and functional connectivity MRI of the MTL in patients receiving CAR-T cells for B cell malignancies. Longitudinal data from four patients is presented here.
RESULTS: Two of the four patients developed ICANS (grade 1 and grade 3), and these patients also experienced mild cytokine release syndrome (CRS, grade 1). No structural abnormalities of the MTL were detected at baseline or during follow-up. CAR-T cell expansion varied markedly between patients. Regardless of ICANS, CRS, or CAR-T cell expansion, patients showed increased MTL perfusion and functional connectivity, most prominently at days 10-14.
CONCLUSION: These data suggest an early, clinically silent inflammatory response in the MTL with potential implications for long-term cognitive function, which requires further investigation.