[Neurotoxicities Associated with CAR-T Cell Therapy]

Chimeric antigen receptor (CAR) T cell therapy has recently approved for CD-19-positive B-cell malignancies, such as acute lymphoblastic leukemia and diffuse large B-cell lymphoma in Japan. CAR-T therapy may develop cytokine release syndoromes as well as central nervous system complications (CRES/ICANS), including encephalopathy, consciousness distrubence, apahsia, seizure, motor weakness, and cerebral edema. Although the pathomechanism of CRES/ICANS remains unsolved, an appropriate intervention is important for patients. In addition, several chemotherapeutic agenets used before CAR-T cell therapy may also lead to the development of central nervous system disorders. Therefore, neurologists must be familiar with the complications of newly developed chemotherapies.