Whole-process management of complications during CAR-T therapy

Abstract

Chimeric antigen receptor T cell (CAR-T) therapy has substantial efficacy in the treatment of relapsed and/or refractory hematological malignancies. However, despite this outstanding performance, various CAR-T complications challenge treatment success during the entire process of CAR-T therapy. Short-term (within 28 days) complications with a high incidence include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome and CAR-T associated coagulopathy. Many other complications may also occur during mid- (28–100 days) and long-term (>100 days) follow-up. Determining how to identify and standardize the management of adverse events in CAR-T therapy in an accurately and timely manner is crucial for its wide application. This review focuses on time periods after CAR-T cell therapy, and discusses the occurrence and management of adverse events, with an aim to improve the safety management of CAR-T cell therapy.