ArticleBone marrow transplantation2025
ICANS risk model in CD19 CAR-T therapy: insights from serum and CSF cytokine profiling.
Article in Bone marrow transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- HLH-like syndromes associate with increased risk of death and CD19- relapse after CAR T in pediatric B-ALL.Blood advances · 2026Observational
- Neural regulation of cancer: from microenvironmental hijacking to systemic circuit co-option.Cellular oncology (Dordrecht, Netherlands) · 2026Review
- Engineered PD1-NKG2D Dual-CAR NK92 cells broaden antitumor target recognition in preclinical tumor models.Journal of translational medicine · 2026Article
- CAR T-Cell Therapy in Neurology: A Scoping Review of Neuro-Oncology, Autoimmune Diseases & Neurotoxicity.Annals of clinical and translational neurology · 2026Article
- Review
- Breaking the resistance barrier: synergistic evolution of CAR-T cells and bispecific antibodies in the era of precision immuno-oncology.Frontiers in immunology · 2026Review
- Reversible cerebral vasoconstriction syndrome following ciltacabtagene autoleucel therapy for relapsed multiple myeloma: a case report.Frontiers in immunology · 2026Article
- Case Report: CAR-T therapy for relapsed diffuse large B-cell lymphoma in a patient with pre-existing Parkinson's disease-unfolding clinical challenges.Frontiers in oncology · 2026Article
- Evaluation of a reference antibody panel for prediction of cytokine release in humanised mouse modelsFrontiers in immunology · 2026Article
- Immune effector cell-associated neurotoxicity syndrome following CAR T-cell therapy: a review of recent advances.Journal of translational medicine · 2025Review
- B-cell activating factor plays a critical role in CAR-T cell-associated cytokine release syndrome.bioRxiv : the preprint server for biology · 2025Article
- Immune effector cell-associated neurotoxicity syndrome: integrative mechanisms, predictive biomarkers, and translational pathways for prevention in CAR T-cell therapy.Frontiers in neurologyReview
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Authors and funding
20 authors.
Funding
Abstract
Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) is a common and potentially severe complication of CD19 CAR-T therapy. While some clinical risk factors have been described, the contribution of cytokines, particularly in plasma and cerebrospinal fluid (CSF), remains limited. This study aimed to identify predictors and characterize cytokine patterns associated with ICANS to develop a multivariable risk model. We retrospectively analyzed 101 adult patients treated with axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) between 2019 and 2023. Cytokines (interleukin (IL)-1β, IL-6, IL-15, GM-CSF) were measured in plasma pre- and post-infusion, and in CSF during neurotoxicity. ICANS occurred in 36% of patients, more frequently with axi-cel (46% vs. 21%, p < 0.05). Autoimmune disease history and elevated IL-6 and IL-15 were associated with increased risk. CSF cytokines were also elevated during ICANS episodes. A multivariate model predicting any-grade ICANS included CAR-T product, time to cytokine release syndrome (CRS) onset, IL-6 at day 3, and pre-infusion D-dimer (AUC = 0.83). The model for grade 2-4 ICANS included number of prior therapies, grade ≥2 CRS, autoimmune disease, IL-15 at day 0, and GM-CSF (AUC = 0.80). Integrating cytokine profiles with clinical parameters may enable early ICANS risk stratification and improve personalized monitoring in CAR-T recipients.
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