RT Journal Article
SR Electronic
T1 Language dysfunction-associated EEG findings in patients with CAR-T related neurotoxicity
JF BMJ Neurology Open
JO BMJ Neurol Open
FD BMJ Publishing Group Ltd
SP e000054
DO 10.1136/bmjno-2020-000054
VO 2
IS 1
A1 Sokolov, Elisaveta
A1 Karschnia, Philipp
A1 Benjamin, Reuben
A1 Hadden, Robert D M
A1 Elwes, Robert C D
A1 Drummond, Lee
A1 Amin, Devyani
A1 Paiva, Vitor
A1 Pennisi, Alex
A1 Herlopian, Aline
A1 Frigault, Matthew
A1 Sanderson, Robin
A1 Inam, Shafqat
A1 Cole, Andrew J
A1 Dietrich, Jorg
YR 2020
UL http://neurologyopen.bmj.com/content/2/1/e000054.abstract
AB Chimeric antigen receptor-modified T cells (CAR-T) have emerged as a promising immunotherapeutic approach in relapsed/refractory haematolgical malignancies. Broader application is limited by unique toxicities, notably, neurotoxicity (NTX). Language dysfunction is among the most frequent symptoms of NTX, the underlying mechanisms of which remain to be elucidated. Electroencephalogram (EEG) is an important tool to monitor for NTX and may provide insights into language dysfunction.Aim We aimed to characterise language dysfunction and define electroencephalographic signatures after CAR-T cell therapy.Methods We reviewed the clinical presentation and EEG findings of 20 adult patients presenting with language dysfunction after CAR-T cell infusion. The cohort included a subset of patients treated with investigational CD19-directed CAR-T cells for non-Hodgkin’s lymphoma (n=17), acute lymphoblastic leukaemia (n=1), follicular lymphoma (n=1) and chronic lymphocytic leukaemia (n=1).Results Language dysfunction presented within 14 days of CAR-T cell infusion in 16 (84%) patients. Ten (50%) patients had mild word-finding difficulties and 10 (50%) had marked dysphasia with profound word-finding difficulties; the latter were all associated with generalised rhythmic delta activity or generalised periodic discharges on EEG.Conclusions Language dysfunction after CAR-T cell therapy is associated with generalised EEG abnormalities.