{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:55:43Z","timestamp":1791924943069,"version":"4.3.4"},"reference-count":7,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,13]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Chimeric antigen receptor (CAR) T-cell therapy is a novel and promising form of cellular immunotherapy using genetically engineered, tumour-specific autologous T cells. CD19-specific CAR T-cells have been shown to be very effective as a treatment for relapsed\/refractory B-cell acute lymphoblastic leukaemia and aggressive B-cell non-Hodgkin\u2019s lymphoma. ICANS (immune effector cell-associated neurotoxicity syndrome) is one of the most frequently occurring toxicities of CAR T-cell treatment. We describe two cases of patients with neurologic symptoms following CAR T-cell infusion who were suspected to have ICANS, but in fact had cerebral toxoplasmosis and venous sinus thrombosis respectively. The focus on CRS and ICANS after CAR T-cell infusion may lead to less vigilance to the \u2018normal\u2019 threats faced by intensively pretreated patients with lymphoma such as infections and thrombosis. Both cases underscore the importance of a broad and thorough examination of patients if they experience neurologic symptoms after CAR T-cell treatment.<\/jats:p>","DOI":"10.1136\/bcr-2019-229946","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T05:16:01Z","timestamp":1573622161000},"page":"e229946","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Unexpected neurologic complications following a novel lymphoma treatment \u2018expected\u2019 to give rise to neurologic toxicity"],"prefix":"10.1136","volume":"12","author":[{"given":"Marie Jos\u00e9","family":"Kersten","sequence":"first","affiliation":[{"name":"Department of Haematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam and LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis N","family":"van Ettekoven","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianne M","family":"Heijink","sequence":"additional","affiliation":[{"name":"Department of Haematology, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,12]]},"reference":[{"key":"2025082709472570000_12.11.e229946.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1407222"},{"key":"2025082709472570000_12.11.e229946.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707447"},{"key":"2025082709472570000_12.11.e229946.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1804980"},{"key":"2025082709472570000_12.11.e229946.4","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2017.148"},{"key":"2025082709472570000_12.11.e229946.5","unstructured":"National Cancer Institute. Common terminology criteria for adverse events (CTCAE). Version 5.0. https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/CTCAE_v5_Quick_Reference_8.5x11.pdf."},{"key":"2025082709472570000_12.11.e229946.6","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-17-0698"},{"key":"2025082709472570000_12.11.e229946.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.758"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229946","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:47:33Z","timestamp":1756313253000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":7,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,12]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bcr-2019-229946"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229946","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}