Cytokine Release Syndrome (CRS)
One of the main risks of Ciltacabtagene autoleucel therapy is cytokine release syndrome (CRS). CRS occurs when the infused CAR-T cells activate the immune system, leading to the release of a large amount of cytokines. This can result in flu-like symptoms such as fever, chills, nausea, and fatigue. In severe cases, CRS can cause organ dysfunction and even be life-threatening. To mitigate the risk of CRS, patients receiving Ciltacabtagene autoleucel therapy are closely monitored, and medications such as tocilizumab or corticosteroids may be administered to manage symptoms.
Neurologic Toxicity
Another potential risk of Ciltacabtagene autoleucel therapy is neurologic toxicity. This can manifest as confusion, seizures, aphasia, or encephalopathy. Neurologic toxicity is believed to be caused by the activation of CAR-T cells in the central nervous system. Prompt recognition and management of neurologic toxicity are important to prevent serious complications. Treatment may involve the administration of supportive care and corticosteroids.
Hematologic Toxicities
Ciltacabtagene autoleucel therapy can also lead to hematologic toxicities, such as a decrease in white blood cells, red blood cells, and platelets. This can result in an increased risk of infections, anemia, and bleeding. Monitoring and management of hematologic toxicities are essential during and after treatment. Patients may require blood transfusions or other supportive care measures.
Infections
Due to the suppression of the immune system during Ciltacabtagene autoleucel therapy, patients are at an increased risk of infections. This includes bacterial, viral, and fungal infections. Preventive measures such as prophylactic antibiotics and antiviral medications may be recommended to reduce the risk of infections. Close monitoring and prompt treatment of infections are necessary.