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Cancer research

Adverse effects of CAR T therapy in blood clearly defined for the first time


Immunotherapy with so-called CAR T cells has become established for the treatment of various leukemias (blood cancers) and lymphomas (cancers of the lymph glands). At the same time, cancer physicians are gaining ever better insights into the spectrum of side effects of the treatment. Having already described the so-called cytokine storm and the side effects in the central nervous system (CNS) and subsequently standardized diagnostics and therapy, the focus is now on hematological side effects, i.e. changes in the blood count.

A team led by Dr. Kai Rejeski and Prof. Marion Subklewe from the LMU Hospital, an international consortium of the European Hematology Association (EHA) and the European Society for Blood and Marrow Transplantation (EBMT) has for the first time uniformly defined the spectrum of side effects in the blood - in the first international guideline that also gives these side effects a binding name: Immune Effector Cell-Associated HematoToxicity (ICAHT), published in the journal Blood.

"We have developed a new system that allows us to clearly define the severity of side effects in the blood, using uniform criteria," says PD Dr. Kai Rejeski. "That was the basis for our new standardized, severity-based therapy recommendations." And Rejeski adds, "This is very important because the side effects in the blood can lead to serious infections and ultimately to the death of the patient." The two researchers expect the new definition to lead to a number of new studies that optimize the management of bloodborne side effects.

Original Publication:

Immune effector cell–associated hematotoxicity: EHA/EBMT consensus grading and best practice recommendations
Rejeski K, Subklewe M, Aljurf M, Bachy E, Balduzzi A, Barba P, Bruno B, Benjamin R, Carrabba MG, Chabannon C, Ciceri F, Corradini P, Delgado J, Di Blasi R, Greco R, Houot R, Iacoboni G, Jäger U, Kersten MJ, Mielke S, Nagler A, Onida F, Peric Z, Roddie C, Ruggeri A, Sánchez-Guijo F, Sánchez-Ortega I, Schneidawind D, Schubert ML, Snowden JA, Thieblemont C, Topp M, Zinzani PL, Gribben JG, Bonini C, Sureda A, Yakoub-Agha I.
Blood. 2023 Sep 7;142(10):865-877.