Non‐ ICANS neurological toxicities associated with BCMA‐ directed CAR T‐cell therapy in patients with plasma cell dyscrasia: A systematic review and pooled analysis
Year: 2026
Type: review
Abstract: To the Editor, Chimeric antigen receptor (CAR) T-cell therapies have revolutionized the treatment of plasma cell dyscrasias. 1 While associated with excellent long-term outcomes, CAR T-cell therapy is also associated with significant side effects.With increasing use, novel adverse events, such as immune colitis, are now being reported.2 Non-Immune Effector cell-associated neurotoxicity syndrome (ICANS) neurotoxicity (NINT) has been increasingly described post CAR T-cell therapy.It has a wide range of clinical presentations, ranging from cranial nerve palsies to Parkinson-like movement and neurocognitive toxicity (MNT).3 The data regarding the incidence of MNTs and NINTs after B-cell maturation antigen (BCMA)= CAR T are evolving, with growing evidence from real-world studies on the true incidence and potential insights into the pathogenesis and appropriate therapy for these syndromes.4 Given the growing utilization of BCMA CAR T-cell therapy, and its use in patients in earlier lines of therapy, more information is needed regarding NINTs to counsel patients better and to have a better sense of the risk-benefit ratio.We conducted a systematic review to study the incidence and outcomes of patients with NINTs post-CAR T-cell therapy in patients with plasma cell dyscrasias.We conducted a comprehensive literature search in PubMed/ MEDLINE, EMBASE, Web of Science and CENTRAL using tailored strategies for each database.The study was registered on PROSPERO (CRD420251074357) and followed the PRISMA reporting guidelines.Two independent authors performed a systematic search.The detailed search strategy is presented in Table S1.Studies published between January 2015 and May 2025 were screened, and the search was limited to prospective clinical trials, randomized controlled trials and prospective and retrospective observational studies with 10 or more patients.Case reports, retrospective case series with fewer than 10 patients, conference abstracts and publications in a language other than English were excluded from the analysis.This was done as the primary outcome of interest was the pooled incidence of NINTs, which could not be calculated
Source: British Journal of Haematology
DOI: 10.1111/bjh.70382
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7130381287