{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T18:58:24Z","timestamp":1785351504535,"version":"3.55.0"},"reference-count":75,"publisher":"American Association for the Advancement of Science (AAAS)","issue":"860","funder":[{"name":"National Cancer Institute (NCI) Core Grant","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}]}],"content-domain":{"domain":["www.science.org"],"crossmark-restriction":true},"short-container-title":["Sci. Transl. Med."],"published-print":{"date-parts":[[2026,7,29]]},"abstract":"<jats:p>\n                    Nonimmune effector cell\u2013associated neurotoxicity syndrome neurotoxicities (NINTs) are serious, atypical toxicities associated with ciltacabtagene autoleucel (cilta-cel), a US Food and Drug Administration chimeric antigen receptor T cell (CAR T cell) therapy approved for relapsed\/refractory multiple myeloma (RRMM). Risk factors contributing to the development of NINTs are poorly understood. In a cohort of 109 patients with RRMM treated with cilta-cel, we identify predisposing risk factors and propose strategies to mitigate NINTs. We show that high-peak absolute lymphocyte count is a strong NINT predictor, which directly correlates with flow cytometry\u2013based peripheral blood CAR T cell quantitation. The observed CAR lymphocytosis was polyclonal with a bias toward CD4\n                    <jats:sup>+<\/jats:sup>\n                    CAR T cells rich in memory marker expression. We then identified CAR lymphocytosis\u2013associated CD4\n                    <jats:sup>+<\/jats:sup>\n                    CAR T cell populations, which exhibited increased inflammatory pathway gene expression. Last, we characterize NINT-associated CD4\n                    <jats:sup>+<\/jats:sup>\n                    CAR T cell populations, which are potential therapeutic targets for future exploration.\n                  <\/jats:p>","DOI":"10.1126\/scitranslmed.aed0039","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T18:00:21Z","timestamp":1785348021000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Robust CD4\n                    <sup>+<\/sup>\n                    CAR T cell expansion is associated with non-ICANS neurotoxicities after ciltacabtagene autoleucel in patients with multiple myeloma"],"prefix":"10.1126","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8280-2581","authenticated-orcid":true,"given":"Eric M.","family":"Jurgens","sequence":"first","affiliation":[{"name":"Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering 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