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Can I read Recurrent Status Epilepticus in the Setting of Chimeric Antigen Receptor (CAR)-T Cell Therapy on EtoBox?
Recurrent Status Epilepticus in the Setting of Chimeric Antigen Receptor (CAR)-T Cell Therapy by Rosyli Reveron-Thornton; Brian J. Scott; David Post; Anna Finley Caulfield; Katherine Werbaneth; Dominic A. Hovsepian; Jay Spiegel; David Miklos; Reena P. Thomas; Chirag B. Patel is a Medicine article available to read on EtoBox.
What is Recurrent Status Epilepticus in the Setting of Chimeric Antigen Receptor (CAR)-T Cell Therapy about?
Axicabtagene ciloleucel (AC) is an FDA-approved anti-CD19 autologous chimeric antigen receptor T-cell (CAR-T) therapy for refractory diffuse large B cell lymphoma (DLBCL). While its efficacy in DLBCL has been promising, neurotoxicity remains a significant concern. We present a case of a 22-year-old woman with chemotherapy-refractory DLBCL who exhibited Grade IV neurotoxicity in the setting of sepsis, after undergoing AC infusion. Despite prophylactic levetiracetam given per guidelines, 1,2 she experienced a precipitous mental status decline on post-infusion day 8 (D8) followed by hypoxic respiratory failure in the setting of clinical status epilepticus on D11 and nonconvulsive status epilepticus (NCSE) on D18. While neuroimaging was unremarkable, EEG demonstrated diffuse slowing and 2.5-3 Hz generalized periodic discharges consistent with NCSE. Seizures were initially refractory to lorazepam, increasing doses of levetiracetam, and phenobarbital, requiring a midazolam drip titrated to 50-70% burst suppression for resolution. Methylprednisolone and tocilizumab were used to treat neurotoxicity and cytokine release syndrome, respectively. Empiric antibiotics were used for sepsis. After
Who reads Recurrent Status Epilepticus in the Setting of Chimeric Antigen Receptor (CAR)-T Cell Therapy?
It is typically read by researchers, students, and practitioners in Medicine.
- Author
- Rosyli Reveron-Thornton; Brian J. Scott; David Post; Anna Finley Caulfield; Katherine Werbaneth; Dominic A. Hovsepian; Jay Spiegel; David Miklos; Reena P. Thomas; Chirag B. Patel
- Publisher
- SAGE Publications
- Published
- 2021
- Language
- EN
- Field
- Medicine (Health Sciences)