Management of a patient with mantle cell lymphoma who developed severe neurotoxicity after chimeric antigen receptor T-cell therapy in ZUMA-2

Michael Wang, Preetesh Jain, T. Linda Chi, Sheree E. Chen, Amy Heimberger, Shiao Pei Weathers, Lianqing Zheng, Arati V. Rao, John M. Rossi

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Cerebral edema following chimeric antigen receptor (CAR) T-cell therapy can be fatal. ZUMA-2 is a pivotal phase 2, multicenter study evaluating KTE-X19, an autologous anti-CD19 CAR T-cell therapy, in relapsed/refractory mantle cell lymphoma. We describe a 65-year-old patient in ZUMA-2 who developed cerebral edema following CAR T-cell therapy and had complete recovery after multimodality clinical intervention including rabbit antithymocyte globulin (ATG). Biomarker results show early and robust CAR T-cell expansion and related induction of inflammatory cytokines, followed by rapid declines in CAR T-cell and proinflammatory cytokine levels after ATG administration. This clinical profile highlights a potential relevance of ATG in treating severe CAR T-cell-related neurotoxicity.

Original languageEnglish (US)
Article numbere001114
JournalJournal for immunotherapy of cancer
Volume8
Issue number2
DOIs
StatePublished - Oct 16 2020

Keywords

  • case reports
  • chimeric antigen

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

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