SynthesisBlood advances2026
Non-ICANS neurologic toxicity after BCMA CAR-T therapy: a systematic review and meta-analysis of 4630 patients with multiple myeloma.
Synthesis in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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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.
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Who cites it
4 citing papers in PubMed.
- Neuralgic Amyotrophy Following B-Cell Maturation Antigen-Directed CAR-T Therapy.Muscle & nerve · 2026Article
- Toward more accurate adverse event attribution in multiple myeloma clinical trials.Blood cancer journal · 2026Review
- Review
- CAR-T Cell Therapy: Engineering Remission in Refractory Myeloma.Cancer journal (Sudbury, Mass.)Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
abstractB-cell maturation antigen (BCMA)-directed chimeric antigen receptor T-cell (CAR-T) therapies have drastically improved outcomes for patients with relapsed or refractory multiple myeloma. Although CAR-T-associated cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome (ICANS) are well characterized, non-ICANS neurologic toxicities (NINTs) remain poorly defined, with limited data regarding incidence and risk factors. We performed a systematic review and meta-analysis of prospective clinical trials and real-world studies reporting neurologic toxicities after BCMA-directed CAR-T therapy, following PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. Random-effects meta-analysis was used to calculate a pooled point estimate of NINTs. Meta-regression was conducted to evaluate treatment-related predictors of risk. Reported NINTs were categorized by clinical phenotype when sufficient detail was available. Fifty-five cohorts comprising 4630 treated patients were included. The pooled point estimate for NINTs was 0.81% (95% confidence interval, 0.37%-1.77%). Incidence differed significantly by product, with a significantly higher frequency of NINTs after ciltacabtagene autoleucel (cilta-cel) than idecabtagene vicleucel (ide-cel; 4.6% vs 0.5%; P = .001) and experimental BCMA-directed constructs (4.6% vs 0.3%; P = .02). Additionally, meta-regression identified cilta-cel as independently associated with increased NINT risk compared with ide-cel. Cranial nerve palsies were the most frequently reported phenotype (32.3%, 43 events), followed by movement and neurocognitive treatment-emergent adverse events (12%, 16 events), then peripheral neuropathies (7.5%, 10 events). This meta-analysis establishes that NINTs are a rare but important toxicity after BCMA-directed CAR-T therapy, particularly cilta-cel. Standardized definitions and improved reporting of NINTs are needed to better characterize risk and inform surveillance strategies.
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