ArticleBlood advances2023
GFAP and NfL increase during neurotoxicity from high baseline levels in pediatric CD19-CAR T-cell patients.
Article in Blood advances, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 28 citations in OpenAlex.
- Point-of-care fresh CAR T cells for pediatric or young adult BCP-ALL that is relapsed/refractory or in very-high-risk first relapse.Blood advances · 2025Trial
- Challenges and advances in CAR-T cell therapy for B-ALL.Biomarker research · 2026Review
- Biomarker-empowered precision navigation of CAR-T cell therapy.Molecular cancer · 2026Review
- Neuronal injury biomarkers GFAP and neurofilament light chains (NfL) are associated with neurotoxicity and endothelial dysfunction in adult patients treated with antiCD19 CART cells.Clinical and experimental medicine · 2026Article
- Critical complications in cancer patients admitted to the ICU in the era of immunotherapy: recognition, differential diagnosis, and management.Frontiers in medicine · 2026Review
- Immune effector cell-associated neurotoxicity syndrome following CAR T-cell therapy: a review of recent advances.Journal of translational medicine · 2025Review
- Biomarker-based profiling of fatigue in childhood cancer survivors: evidence for distinct inflammatory and glial-associated profiles.Brain, behavior, & immunity - health · 2025Article
- Severity-Dependent Neuroaxonal Damage Assessed by Serum Neurofilaments in ICANS Patients Undergoing CD19-Targeted CAR T-Cell Therapy.European journal of neurology · 2025Article
- Longitudinal evaluation of serum neurofilament light levels in normal healthy volunteers: defining a threshold of concern.Journal of neurology · 2025Article
- Baseline Cognitive and Neurological Status Does Not Modify the Occurrence of ICANS in CAR T-Cell Therapy for Aggressive B-Cell Lymphoma.European journal of neurology · 2025Article
- The Struggle Between Chimeric Antigen Receptor T-Cell Therapy and Neurological Complications in Acute Lymphoblastic Leukemia Treatment.Current issues in molecular biology · 2025Review
- Increased serum NfL and GFAP levels indicate different subtypes of neurologic immune-related adverse events during treatment with immune checkpoint inhibitors.International journal of cancer · 2025Article
- CD147-CAR-NK cell therapy shows minimal toxicities in human CD147 transgenic mouse model with solid tumors.Molecular therapy. Oncology · 2025Article
- Investigating the Impact of Zinc Oxide Nanoparticles and Folic Acid on Neuronal Markers in a Rat Model of Nanotoxicity.Journal of toxicology · 2025Article
- Article
- The protective role of L-carnitine on oxidative stress, neurotransmitter perturbations, astrogliosis, and apoptosis induced by thiamethoxam in the brains of male rats.Naunyn-Schmiedeberg's archives of pharmacology · 2024Article
- Clinical features of neurotoxicity after CD19 CAR T-cell therapy in mantle cell lymphoma.Blood advances · 2024Article
- Biomarkers for prediction of CAR T therapy outcomes: current and future perspectives.Frontiers in immunology · 2024Review
- Systemic toxicity of CAR-T therapy and potential monitoring indicators for toxicity prevention.Frontiers in immunology · 2024Review
- How I treat unique and difficult-to-manage cases of CAR T-cell therapy-associated neurotoxicity.Blood · 2023Article
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
There is a need for biomarkers to predict and measure the severity of immune effector cell-associated neurotoxicity syndrome (ICANS). Glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) are well-validated biomarkers of astroglial and neuronal injury, respectively. We hypothesized that pretreatment GFAP and NfL levels can predict the risk of subsequent ICANS and that increases in GFAP and NfL levels during treatment reflect ICANS severity. We measured cerebrospinal fluid GFAP (cGFAP) and NfL (cNfL) along with serum NfL (sNfL) levels at pretreatment and day 7 to 10 after chimeric antigen receptor (CAR) T-cell infusion in 3 pediatric cohorts treated with CD19- or CD19/CD22-directed CAR T cells. cGFAP and cNfL levels increased during grade ≥1 ICANS in patients treated with CD19-directed CAR T cells but not in those who received CD19/CD22-directed CAR T cells. The sNfL levels did not increase during ICANS. Prelymphodepletion cGFAP, cNfL, and sNfL levels were not predictive of subsequent ICANS. Elevated baseline cGFAP levels were associated with a history of transplantation. Patients with prior central nervous system (CNS) radiation had higher cNfL levels, and elevated baseline sNfL levels were associated with a history of peripheral neuropathy. Thus, cGFAP and cNfL may be useful biomarkers for measuring the severity of CNS injury during ICANS in children. Elevated baseline levels of cGFAP, cNfL, and sNfL likely reflect the cumulative injury to the central and peripheral nervous systems from prior treatment. However, levels of any of the 3 biomarkers before CAR T-cell infusion did not predict the risk of ICANS.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.