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A review of neurotoxicities associated with immunotherapy and a framework for evaluation.

Immuno-oncology agents, including immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T (CAR-T) cell therapies, are increasing in use for a growing list of oncologic indications. While harnessing the immune system against cancer cells has a potent anti-tumor effect, it can also cause widespread autoimmune toxicities that limit therapeutic potential. Neurologic toxicities have unique presentations and can progress rapidly, necessitating prompt recognition. In this article, we review the spectrum of central and peripheral neurologic immune-related adverse events (irAEs) associated

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… Sign or Symptom | Grade 1 | Grade 2 | Grade 3 | Grade 4 Impaired Consciousness | Awakens spontaneously | Awakens to voice | Awakens only to tactile stimulation | Unarousable or requires vigorous or repetitive tactile stimuli to arouse; stupor or coma Cognitive Impairment | ICE score 7–9 | ICE score 3 …

Ход работы 34th Симпозиум ESVN-ECVN 23rd-24th сентябрь 2022.

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CAR-T cell therapy: A new dawn in the treatment of autoimmune disease.

Autoimmune diseases (AIDs) are a class of diseases caused by autoimmune intolerance, which can be divided into systemic and organ-specific diseases. AIDs affect approximately 10% of the global population and rank among the leading causes of disability and mortality. At present, immunosuppressive agents are the first choice for the treatment of AIDs. B-cell-targeted therapies-particularly CD20 monoclonal antibodies-have brought new hope for systemic AIDs, yet a subset of patients still respond poorly. As a rapidly developing cellular immunotherapy technology, Chimeric antigen receptor T cell (C

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… norepinephrine | High flow oxygen intake | Awakening only to tactile stimulus | 0–2 | Any clinical seizure or non-convulsive seizures on electrocardiograph that resolve with intervention, and/or focal edema on neuroimaging 4 | ≥38.0°C | Multiple pressor medications are required | Positive pressure ventilation | Stupor …

Cancer-associated stroke: Pathophysiology, detection and management (Review).

Numerous types of cancer have been shown to be associated with either ischemic or hemorrhagic stroke. In this review, the epidemiology and pathophysiology of stroke in cancer patients is discussed, while providing vital information on the diagnosis and management of patients with cancer and stroke. Cancer may mediate stroke pathophysiology either directly or via coagulation disorders that establish a state of hypercoagulation, as well as via infections. Cancer treatment options, such as chemotherapy, radiotherapy and surgery have all been shown to aggravate the risk of stroke as well. The clin

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… The CNS symptoms range from nausea, tinnitus, visual impairment, ataxia, psychiatric manifestations such as agitation or delirium, to mental status disorders, with somnolence, stupor and even coma. The respiratory involvement varies and can lead to acute respiratory failure. …

Toxicity Profile of Chimeric Antigen Receptor T-Cell and Bispecific Antibody Therapies in Multiple Myeloma: Pathogenesis, Prevention and Management.

Multiple myeloma is the second-most common hematologic malignancy in adults worldwide. Despite ongoing advancement in therapeutic modalities, it remains an incurable disease with a 5-year survival rate of approximately 50%. The recent development and introduction of anti-BCMA immunotherapies into clinical practice, including chimeric antigen receptor T-cell (CAR-T) therapies and bispecific antibodies, has radically shifted the treatment paradigm. However, despite the promising potential of these therapies for broader application, frequent and significant adverse effects have been reported, bot

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… awakens to voice | depressed level of consciousness: only awakens to tactile stimulus or seizures (focal, generalized, non-convulsive seizures on EEG) or raised ICP with focal/local on imaging | depressed level of consciousness: unarousable or arousable only with vigorous or repetitive tactile stimuli; stupor …

Toxicities of Chimeric Antigen Receptor T Cell Therapy in Multiple Myeloma: An Overview of Experience From Clinical Trials, Pathophysiology, and Management Strategies.

In the last few years, monoclonal antibodies (mAbs) such as elotuzumab and daratutumab have brought the treatment of multiple myeloma (MM) into the new era of immunotherapy. More recently, chimeric antigen receptor (CAR) modified T cell, a novel cellular immunotherapy, has been developed for treatment of relapsed/refractory (RR) MM, and early phase clinical trials have shown promising efficacy of CAR T cell therapy. Many patients with end stage RRMM regard CAR T cell therapy as their "last chance" and a "hope of cure". However, severe adverse events (AEs) and even toxic death related to CAR T

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… Stupor or coma Seizure | No | No | Any clinical seizure that resolves rapidly or non-convulsive seizures on EEG that resolve with intervention | Life-threatening prolonged seizure (>5 min) or repetitive clinical or electrical seizures without return to baseline in between Motor findings | No | No | No …

Evolving strategies for addressing CAR T-cell toxicities.

The field of chimeric antigen receptor (CAR) T-cell therapy has grown from a fully experimental concept to now boasting a multitude of treatments including six FDA-approved products targeting various hematologic malignancies. Yet, along with their efficacy, these therapies come with side effects requiring timely and thoughtful interventions. In this review, we discuss the most common toxicities associated with CAR T-cells to date, highlighting risk factors, prognostication, implications for critical care management, patient experience optimization, and ongoing work in the field of toxicity mit

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… ASTCT 2019 guidelines, patients ≥ 12 years Grade 1 : ICE 7–9; awakens spontaneously Grade 2 : ICE 3–6; awakens to voice Grade 3 : ICE 0–2; awakens only to tactile stimulus; clinical seizure that resolves or nonconvulsive seizure that resolves with intervention; focal edema Grade 4 : ICE 0; unarousable, stupor … ASTCT 2019 guidelines, patients ≥ 12 years Grade 1 : ICE 7–9; awakens spontaneously Grade 2 : ICE 3–6; awakens to voice Grade 3 : ICE 0–2; awakens only to tactile stimulus; clinical seizure that resolves or nonconvulsive seizure that resolves with intervention; focal edema Grade 4 : ICE 0; unarousable, stupor …

Diseases of the Nervous System

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… Other abnormal mental states include stupor, somnolence, deliriousness, lethargy, and depression. Animals may exhibit opisthotonus, either spontaneously or in response to stimulation ( Fig. 14-1 ). …

Mechanisms and management of CAR T toxicity.

Chimeric antigen receptor (CAR) T cell therapies have dramatically improved treatment outcomes for patients with relapsed or refractory B-cell acute lymphoblastic leukemia, large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, and multiple myeloma. Despite unprecedented efficacy, treatment with CAR T cell therapies can cause a multitude of adverse effects which require monitoring and management at specialized centers and contribute to morbidity and non-relapse mortality. Such toxicities include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, neuro

Совпадение в полном тексте источника
… Stupor or coma Seizure | N/A | N/A | Any clinical seizure focal or generalized that resolves rapidly or nonconvulsive seizures on EEG that resolve with intervention | Life-threatening prolonged seizure (>5 min); or repetitive clinical or electrical seizures without return to baseline in between Motor …

The Continuum of Thyroid Disorders Related to Immune Checkpoint Inhibitors: Still Many Pending Queries.

BackgroundUntil more data are available to shed light on the thyroid disorders related to immune checkpoint inhibitors (ICPi) implemented for the treatment of hematological malignancies, the decision-making is guided by pertinent data derived mostly from solid tumors.MethodsThe present review provides a comprehensive and updated overview of the thyroid disorders related to ICPi, namely to inhibitors of cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death (PD) 1 (PD-1), and the ligand of the latter (PD-L1).ResultsWith the increasing recognition of ir thyroid disorders, many outstand

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… A point scale for the diagnosis of a thyroid storm has been suggested based on precise criteria, including tachycardia, arrhythmias, congestive heart failure, hypotension, hyperpyrexia, agitation, delirium, psychosis, a stupor, and a coma, as well as nausea, vomiting, diarrhea, and hepatic failure [ …

Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune effector cell-related adverse events.

Immune effector cell (IEC) therapies offer durable and sustained remissions in significant numbers of patients with hematological cancers. While these unique immunotherapies have improved outcomes for pediatric and adult patients in a number of disease states, as 'living drugs,' their toxicity profiles, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), differ markedly from conventional cancer therapeutics. At the time of article preparation, the US Food and Drug Administration (FDA) has approved tisagenlecleucel, axicabtagene ciloleuc

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… domain | Grade 1 | Grade 2 | Grade 3 | Grade 4 ICE score* | 7–9 | 3–6 | 0–2 | 0 (patient is unarousable) Depressed level of consciousness† | Awakens spontaneously | Awakens to voice | Awakens only to tactile stimulus | Patient is unarousable or requires vigorous or repetitive tactile stimuli to arouse; stupor …

Proceedings of Réanimation 2020, the French Intensive Care Society International Congress.

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Mechanisms to medicines: navigating drug repurposing strategies in Alzheimer's disease.

Alzheimer's disease (AD) represents a continuously advancing neurodegenerative condition distinguished by the unremitting deterioration of cognitive abilities and memory impairment, which significantly hampers daily functioning of life. In the absence of disease modifying treatments, it continues to pose a significant global challenge. Though symptomatic treatment exists, the inherent complexity involved with AD pathogenesis related to Aβ plaques, neurofibrillary tangles, neuroinflammation, oxidative stress, etc. poses a tremendous challenge to developing drugs. With the incidence of AD increa

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… synaptic plasticity in brain, improve memory • Neuroprotective | • Reduces calcium influx to protect neurons • Leads to the improvement of Alzheimer’s disease symptoms • Good CNS effects | Dizziness, headaches. constipation, shortness of breath Overdose: ECG change, bradycardia, increased blood pressure, stupor …

Development of CAR T Cell Therapy in Children-A Comprehensive Overview.

CAR T cell therapy has revolutionized immunotherapy in the last decade with the successful establishment of chimeric antigen receptor (CAR)-expressing cellular therapies as an alternative treatment in relapsed and refractory CD19-positive leukemias and lymphomas. There are fundamental reasons why CAR T cell therapy has been approved by the Food and Drug administration and the European Medicines Agency for pediatric and young adult patients first. Commonly, novel therapies are developed for adult patients and then adapted for pediatric use, due to regulatory and commercial reasons. Both strateg

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… Neurotoxicity A range of neurologic symptoms after CAR T cell administration including headache, tremor, speech impairment, confusion, delirium, and reduced consciousness (lethargy, stupor, obtundation) are in the scope of the clinical presentation of ICANS [ 28 ]. …

Rare Diseases of the Orbit.

This article provides an overview of rare orbital diseases. Congenital malformations, inflammatory diseases, benign and malignant neoplasias are described. Although it represents a relatively small area of the body the orbit contains multiple different tissues. Therefore, a great variety of diseases can be found within the orbital space. That is the reason, why both the completeness and the level of detail in the description of particular diseases must be somewhat limited. Nevertheless, clinical manifestations, important aspects of diagnosis, treatment strategies, and, when specific data are a

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… deferoxamine, AIDS Clinical general symptoms: fever, fatigue, pharyngitis rhino-orbital symptoms: acute pansinusitis with purulent rhinorrhea, pain, and massive crust formation (black crusts at the nose and palate), subsequent apex-orbital syndrome with sudden loss of vision and ophthalmoplegia, stupor …

ИАНКОН 2023 Выдержки из плаката

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Abstracts - IANCON 2024

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Proceedings of the RAMI Intern Section Meeting.

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ECC-4 Abstracts

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Abstracts of the ICARE 2024 78th SIAARTI National Congress

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