eJHaem (May 2022)

Extensive myelitis with eosinophilic meningitis after Chimeric antigen receptor T cells therapy

  • Baptiste Le Calvez,
  • Marion Eveillard,
  • Paul Decamps,
  • Jesus Aguilar,
  • Amélie Seguin,
  • Emmanuel Canet,
  • Audrey Grain,
  • Cyrille Touzeau,
  • Benoît Tessoulin,
  • Thomas Gastinne

DOI
https://doi.org/10.1002/jha2.381
Journal volume & issue
Vol. 3, no. 2
pp. 533 – 536

Abstract

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Abstract Immune effector cell‐associated neurotoxicity syndrome (ICANS) is a frequent adverse event after Chimeric antigen receptor T cells (CAR‐T cells). A patient treated with anti‐CD19 CAR‐T cells for a refractory mantle cell lymphoma presented at Day 8 post‐infusion with extensive myelitis. Unusual eosinophilia was disclosed in the patient's cerebrospinal fluid. After treatment with methylprednisolone and siltuximab, a decrease in clinical symptoms and magnetic resonance imaging lesions were obtained. This unprecedented presentation of eosinophilic meningitis after CAR‐T cells therapy highlights the need for a better understanding of the physiopathology of ICANS, especially to identify potentially targetable pathways.

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