Associated Toxicities: Assessment and Management Related to CAR T-Cell Therapy

Karen Anderson, MN, RN, AOCNS®, BMTCN®, CRNI; Theresa Latchford, MS, RN, CNS, AOCNS®, BMTCN®


Background: The impressive disease response observed with chimeric antigen receptor (CAR) T-cell therapy is accompanied by the potential for unique and severe toxicities. Cytokine release syndrome (CRS) and neurologic toxicities have emerged as prominent toxicities associated with this treatment modality.

Objectives: This article presents an overview of pathophysiology, assessment, and evidence-based management of CAR T-cell therapy–associated toxicities, with particular attention paid to CRS and neurologic toxicity management. Implications for nursing practice are included for prominent toxicities to guide clinical practice.

Methods: An overview of recent guidelines and evidence for CAR T-cell therapy toxicity assessment and management is provided.

Findings: Evidence-based approaches to CAR T-cell therapy toxicities continue to evolve. As organizational and institutional guidelines emerge, nurses must be aware of anticipated toxicities and interventions used in clinical practice to provide timely and effective care.

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