Evidence map›Paper›PMID 39252328›Full record

ArticleMedicine2024

Autonomic dysfunction as manifestation of ICANS: A case report.

Dina Rochate, Antonio Manuel González-García, Carmen Santos Marcos, Estefanía Pérez-López, Ana-África Martín-López, Mónica Alaña, Lourdes Martín Martín, Miriam López Parra, Fermín Sánchez Guijo, Lucía López Corral

Abstract readCase Reports
In one paragraph

Article in Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Dina RochateHematology Department, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal.ORCID 0000-0001-9965-7173
Antonio Manuel González-GarcíaNeurology Department, University Hospital of Salamanca, Salamanca, Spain.
Carmen Santos MarcosHematology Department, University Hospital of Salamanca-IBSAL, Centro de Investigación del Cáncer, Salamanca, Spain.
Estefanía Pérez-LópezHematology Department, University Hospital of Salamanca-IBSAL, Centro de Investigación del Cáncer, Salamanca, Spain.
Ana-África Martín-LópezHematology Department, University Hospital of Salamanca-IBSAL, Centro de Investigación del Cáncer, Salamanca, Spain.
Mónica AlañaNeurology Department, University Hospital of Salamanca, Salamanca, Spain.
Lourdes Martín MartínHematology Department, University Hospital of Salamanca-IBSAL, Centro de Investigación del Cáncer, Salamanca, Spain.
Miriam López ParraHematology Department, University Hospital of Salamanca-IBSAL, Centro de Investigación del Cáncer, Salamanca, Spain.
Fermín Sánchez GuijoHematology Department, University Hospital of Salamanca-IBSAL, Centro de Investigación del Cáncer, Salamanca, Spain.
Lucía López CorralHematology Department, University Hospital of Salamanca-IBSAL, Centro de Investigación del Cáncer, Salamanca, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleAnti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy is a successful treatment for B-cell malignancies associated with cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Cardiovascular toxicities have also been reported in this setting. However, there is scarce data regarding development of autonomic disorders after CAR-T cell therapy. PATIENT CONCERNS: We report a case with a patient with non-Hodgkin B-cell lymphoma, refractory to 2 prior lines of immunochemotherapy, treated with CAR-T therapy. DIAGNOSES: Orthostatic hypotension secondary to autonomic dysfunction was diagnosed as manifestation of ICANS.

interventionsThe patient received metilprednisolone 1000 mg IV daily for 3 days and anakinra 100 mg IV every 6h. OUTCOMES: The vast majority of autonomic symptoms ceased and 4 months after CAR-T therapy, autonomic dysfunction was resolved. LESSONS: New-onset autonomic dysfunction can occur as manifestation of ICANS in patients who experience persistent neurologic and cardiovascular symptoms after resolution of acute neurotoxicity and should be early recognized. Differences in differential diagnosis, mechanisms and treatment approaches are discussed.

Indexed as

Autonomic Nervous System DiseasesCytokine Release SyndromeHumansHypotension, OrthostaticImmunotherapy, AdoptiveLymphoma, B-CellMaleMethylprednisoloneMiddle AgedNeurotoxicity SyndromesMethylprednisolone

Identifiers

PMID39252328
PMCPMC12431755

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