Cyclophosphamide mitigates non-ICANS neurotoxicities following ciltacabtagene autoleucel treatment

Viktoria Blumenberg; Benjamin R Puliafito; Charlotte E Graham; Mark B Leick; Md Raihan Chowdhury; Maxx King; Deshea L Harris; Noopur S Raje; Andrew R Branagan; Andrew J Yee; Diana Cirstea; Kathleen M E Gallagher; Jörg Dietrich; Marcela V Maus; Matthew J Frigault

doi:10.1182/blood.2024028172

Cyclophosphamide mitigates non-ICANS neurotoxicities following ciltacabtagene autoleucel treatment

Blood. 2025 Jun 5;145(23):2788-2793. doi: 10.1182/blood.2024028172.

Authors

Viktoria Blumenberg¹, Benjamin R Puliafito^{1

2}, Charlotte E Graham³, Mark B Leick^{1

2}, Md Raihan Chowdhury¹, Maxx King¹, Deshea L Harris¹, Noopur S Raje^{1

2}, Andrew R Branagan^{1

2}, Andrew J Yee^{1

2}, Diana Cirstea^{1

2}, Kathleen M E Gallagher¹, Jörg Dietrich^{1

4}, Marcela V Maus^{1

2}, Matthew J Frigault^{1

2}

Affiliations

¹ Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA.
² Hematology and Oncology Division, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA.
³ Department of Haematology, Comprehensive Cancer Centre, King's College London, London, United Kingdom.
⁴ Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA.

PMID: 40163799
DOI: 10.1182/blood.2024028172

Abstract

Potentially fatal non-immune effector cell-associated neurotoxicity syndrome neurotoxicities (NINTs) after B-cell maturation antigen-targeted chimeric antigen receptor (CAR) T-cell therapy have been linked to high CAR T-cell expansion. Cyclophosphamide to ablate CAR T cells is an effective strategy to mitigate steroid-refractory NINTs.

Publication types

Case Reports
Letter

MeSH terms

Antigens, CD19* / adverse effects
Biological Products
Cyclophosphamide* / therapeutic use
Humans
Immunotherapy, Adoptive* / adverse effects
Neurotoxicity Syndromes* / drug therapy
Neurotoxicity Syndromes* / etiology
Neurotoxicity Syndromes* / prevention & control
Receptors, Chimeric Antigen*

Substances

Antigens, CD19
axicabtagene ciloleucel
Cyclophosphamide
Receptors, Chimeric Antigen
Biological Products