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These genetically engineered T\u2010cells have shown encouraging results for B\u2010cell lymphoid malignancies and are now being explored for other cancer types. However, this novel adoptive cell therapy is associated with a new spectrum of immune\u2010mediated adverse events and toxicities. As CAR T cells recognize and engage tumour cells, cytokines are secreted and activate other immune cells, frequently leading to rapid development of cytokine release syndrome, which can result in acute deterioration of the patient's clinical condition. In many patients, cytokine release syndrome is mild and easy to manage, but others experience persistent fevers accompanied by hypotension and hypoxia, which require management with immune\u2010modulatory agents. Another deleterious effect of cytokines released by effector cells is immune effector cell\u2013associated neurotoxicity syndrome. This syndrome, caused by a disruption of the blood\u2013brain barrier as a consequence of the immune process, can result in rapid deterioration in cognitive function. This is often associated with subtle changes in handwriting, often progressing to loss of memory and concentration and reduced ability to name objects or follow commands. In some cases, the neurological state is further compromised by seizures and in rare instances with fulminant life\u2010threatening cerebral oedema. In this review, we discuss these toxicities, as well as other CAR T\u2010cell\u2013related immune phenomenon, and address their clinical manifestations, grading, and management options.<\/jats:p>","DOI":"10.1111\/bcp.14403","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T14:31:55Z","timestamp":1590676315000},"page":"2414-2424","source":"Crossref","is-referenced-by-count":25,"title":["Chimeric antigen receptor T\u2010cell therapy toxicities"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8582-4572","authenticated-orcid":false,"given":"Uri","family":"Greenbaum","sequence":"first","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partow","family":"Kebriaei","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer A.","family":"Srour","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Olson","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qaiser","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sattva S.","family":"Neelapu","sequence":"additional","affiliation":[{"name":"Department of Lymphoma\/Myeloma The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katayoun","family":"Rezvani","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J.","family":"Shpall","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011795"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-01-0016"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(06)70664-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-08-595801"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.0410"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509277"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-06-651380"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2015.214"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)70054-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1305133"},{"key":"e_1_2_7_12_1","first-page":"56","article-title":"Allogeneic transplantation for AML and MDS: GVL versus GVHD and disease recurrence","volume":"2013","author":"Besien K","year":"2013","journal-title":"ASH Educ Program Book"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.90.2.720"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-1183"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2019-131077"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.758"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2017.148"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_238691"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-018-0075-2"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.229781"},{"key":"e_1_2_7_21_1","unstructured":"The University of Texas MD Anderson Cancer Center.IEC Therapy Toxicity Assessment and Management (also known as CARTOX) \u2013 Adult. 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