Monitoring the neurological complications of chimeric antigen receptor (CAR) T-cell therapy in patients with sensory and physical impairments and non-native-speaking backgrounds using modified immune effector cell-associated encephalopathy (ICE) scores: a case series.
Christina Kazzi, Ty Simpson, Cassandra Abbott, Miriam Wronski, Nabil Seery, Tracie Huey-Lin Tan, Robb Wesselingh, Katherine Ko, Shu Min Wong, Shafqat Inam, Constantine Tam, Shaun Fleming, Terence J O'Brien, Rubina Alpitsis, Andrew Spencer, Charles Malpas, Mastura Monif
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Abstract
Background: Immune effector cell-associated neurotoxicity syndrome (ICANS) is a common complication of chimeric antigen receptor (CAR) T-cell therapy. Current practice guidelines recommend the immune effector cell-associated encephalopathy (ICE) score for the assessment and monitoring of ICANS.
Objective: To demonstrate modifications to ICE score to patients with vision and hearing impairments or who are who are from non-native-speaking backgrounds.
Methods: We discuss five cases and the modifications made to adapt the ICE score to meet patients' needs.
Results: Modifications to ICE score was feasible and it assisted with CAR T cell therapy outcome monitoring.
Discussion: These cases highlight the need for flexible and patient-tailored strategies and the importance of collaboration between multidisciplinary teams and patients' families/caregivers when monitoring patients for ICANS after CAR T-cell therapy.
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