Evidence map›Paper›PMID 40111490›Full record

ArticleEuropean radiology2025

Brain MRI changes in children and young adults with B-cell acute lymphoblastic leukemia following chimeric antigen receptor T-cell therapy.

Hyun Gi Kim, Kristen W Yeom, Iryna Vasyliv, Zahra Shokri Varniab, Courtney Erickson, Christina Baggott, Liora Michal Schultz, Heike E Daldrup-Link

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Imaging the efficacy and side effects of CAR T-cell therapy in children and young adults.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026
    Review
  2. Observational
  3. 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

8 authors.

Hyun Gi KimDepartment of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, CA, USA.
Kristen W YeomDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
Iryna VasylivDepartment of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, CA, USA.
Zahra Shokri VarniabDepartment of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, CA, USA.
Courtney EricksonDepartment of Pediatrics, Bass Center for Childhood Cancer and Blood Disorders, Center for Cancer Cell Therapy, Stanford University, Stanford, CA, USA.
Christina BaggottDepartment of Pediatrics, Bass Center for Childhood Cancer and Blood Disorders, Center for Cancer Cell Therapy, Stanford University, Stanford, CA, USA.
Liora Michal SchultzDepartment of Pediatrics, Bass Center for Childhood Cancer and Blood Disorders, Center for Cancer Cell Therapy, Stanford University, Stanford, CA, USA.
Heike E Daldrup-LinkDepartment of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, CA, USA. heiked@stanford.edu.ORCID http://orcid.org/0000-0002-4929-819X

Funding

Advanced Imaging Tools to Assess Cancer Therapeutics in Pediatric PatientsR01CA269231 · NCI · STANFORD UNIVERSITY · PI Heike Elizabeth Daldrup-Link · 2022 to 2026
$3.5M
NCI NIH HHS R01 CA269231NCI NIH HHS R01CA269231
6 · The paper itself

Abstract

objectiveTo evaluate brain MRI findings in children and young adults after chimeric antigen receptor (CAR) T-cell therapy for B-cell acute lymphoid leukemia (B-ALL) and associate results with clinical and neurological symptoms.

methodsWe reviewed pre- and post-CAR-T cell therapy brain MRIs of B-ALL patients aged 25 years or younger who underwent therapy between April 2015 and October 2023 at a single institution. MRI abnormalities were categorized as no change, exacerbation of preexisting lesion, or newly developed lesion. Clinical CAR-mediated toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) grades, were recorded. Patients were grouped into those with and without 'exacerbated/new lesion,' and clinical and neurological symptoms were compared using Fisher's exact test.

resultsSixteen patients with pre- and post-CAR brain MRIs (median age 16 years [interquartile range, 11-21]; 9 males, 7 females) were included in the analysis. Post-CAR brain abnormalities were observed in 81% (13/16) of patients, including white matter (WM) signal changes (12/16), leptomeningeal enhancement (1/16), and cerebellar embolic infarction (1/16). Of the post-CAR WM lesions, 50% (6/12) were exacerbated, 33% (4/12) were newly developed, and 17% (2/12) remained unchanged compared to pre-CAR brain MRI. No difference in CRS (p = 0.079) or ICANS grades (p > 0.99) was observed between patients with and without 'exacerbated/new lesions'.

conclusionChildren and young adults with B-ALL can develop brain MRI abnormalities after CAR T-cell therapy, predominantly WM signal changes. These brain abnormalities did not show an association with higher CRS or ICANS grade. KEY POINTS: Question Brain MRI findings after chimeric antigen receptor (CAR) T-cell therapy for B-cell acute lymphoid leukemia (B-ALL) and their association with clinical and neurological symptoms are not well understood. Findings Brain MRI abnormalities, mostly white matter changes, were seen in 81% of patients but were not associated with CAR-mediated toxicities. Clinical relevance Brain MRI abnormalities, commonly observed post-CAR T-cell therapy, do not correlate with the severity of CAR-related toxicities, aiding in the clinical management and monitoring of these patients.

Indexed as

BrainImmunotherapy, AdoptiveMagnetic Resonance ImagingPrecursor B-Cell Lymphoblastic Leukemia-LymphomaAdolescentChildFemaleHumansMaleReceptors, Chimeric AntigenRetrospective StudiesYoung AdultReceptors, Chimeric AntigenBrainCAR-T cell therapyCytokinerelease syndromeImmune effector cell-associated neurotoxicity syndromeMRI

Identifiers

PMID40111490
PMCPMC12333318

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.