{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:36:50Z","timestamp":1791333410964,"version":"4.3.1"},"reference-count":39,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2020,4,22]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec id=\"s1\">\n                    <jats:title\/>\n                    <jats:p>Chimeric antigen receptor (CAR) T-cell therapy is one of the most innovative therapies for haematological malignancies to emerge in a generation. Clinical studies have shown that a single dose of CAR T-cells can deliver durable clinical remissions for some patients with B\ufeff-cell cancers where conventional therapies have failed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s2\">\n                    <jats:title\/>\n                    <jats:p>A significant complication of CAR therapy is the immune effector cell-associated neurotoxicity syndrome (ICANS). This syndrome presents a continuum from mild tremor to cerebral oedema and in a minority of cases, death. Management of ICANS is mainly supportive, with a focus on seizure prevention and attenuation of the immune system, often using corticosteroids. Parallel investigation to exclude other central nervous system pathologies (infection, disease progression) is critical. In this review, we discuss current paradigms around CAR T-cell therapy, with a focus on appropriate investigation and management of ICANS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/practneurol-2020-002550","type":"journal-article","created":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T17:25:37Z","timestamp":1591377937000},"page":"285-293","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Neurotoxicity\u2014CAR T-cell therapy: what the neurologist needs to know"],"prefix":"10.1136","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3108-0974","authenticated-orcid":false,"given":"Lorna","family":"Neill","sequence":"first","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Rees","sequence":"additional","affiliation":[{"name":"Neurology, National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Roddie","sequence":"additional","affiliation":[{"name":"University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"2025090410515358000_20.4.285.1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1706169"},{"key":"2025090410515358000_20.4.285.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709866"},{"key":"2025090410515358000_20.4.285.3","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1080\/10428194.2017.1387905","article-title":"Axicabtagene ciloleucel, a first-in-class CAR T cell therapy for aggressive NHL","volume":"59","author":"Roberts","year":"2018","journal-title":"Leuk Lymphoma"},{"key":"2025090410515358000_20.4.285.4","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.jcyt.2018.11.009","article-title":"Manufacturing chimeric antigen receptor T cells: issues and challenges","volume":"21","author":"Roddie","year":"2019","journal-title":"Cytotherapy"},{"key":"2025090410515358000_20.4.285.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1804980"},{"key":"2025090410515358000_20.4.285.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707447"},{"key":"2025090410515358000_20.4.285.7","unstructured":"FDA . 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