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CAR-T cell therapy recipient in the ICU - EMCrit Project
CAR-T lab panel (obtained daily for patients with CRS and or ICANS): Electrolytes, including Ca Mg Phos and uric acid Complete blood count with differential INR, PTT, fibrinogen CRP and ferritin Infection evaluation: Blood cultures x2 Urinalysis and urine culture (if clinically appropriate)
Practical guidelines for monitoring and management of coagulopathy . . .
Cytokine release syndrome (CRS) is a systemic inflammatory response associated with chimeric antigen receptor T-cell (CAR-T) therapies In severe cases, CRS can be associated with coagulopathy and hypofibrinogenemia
Guidelines for management of Cytokine Release Syndrome
High risk testing schedule is as below: Patients developing CRS will typically show laboratory evidence of acute inflammation (raised CRP and ferritin) and may develop hypofibrinogenaemia (see SOP: Inpatient Management of patients receiving Immune Effector Cells (including CAR-T Cells)
Grading of cytokine release syndrome associated with the CAR T cell . . .
Cytokine release syndrome (CRS) is the most significant complication associated with CAR T cell therapy, and it is critical to have a reproducible and easy method to grade CRS after CAR T cell infusions
UpToDate
CRS is most often associated with chimeric antigen receptor (CAR)-T cell therapy, but it also occurs in association with bispecific T cell engager therapy, other monoclonal antibody-based therapy, haploidentical allogeneic transplantation, and other settings
Management of Cytokine Release Syndrome Associated with Bispecific T . . .
1 describes the management strategies of CRS in patients receiving tient will check temperature and blood pressure every 2 hours while awake at home Call clinic for advisement if blood pressure goes <10 mmHg below baseline AND <90 mmHg systol methasone 16 mg by mouth may be given and repeate
Pathogenesis, Diagnosis, and Management of Cytokine Release Syndrome in . . .
Accurate diagnosis of CRS requires careful clinical assessment and biomarker evaluation, with emerging tools such as cytokine-based models showing promise in distinguishing CRS from sepsis and other infectious complications [5, 39] Antimicrobial therapy plays a crucial role in the empiric management of CRS, especially when infections co-occur
Cytokine Release Syndrome Testing: Mechanisms Impacts
Laboratory Testing for Cytokine Release Syndrome Understanding the laboratory testing for Cytokine Release Syndrome (CRS) is pivotal for both clinicians and researchers Accurate lab tests can provide crucial information necessary for diagnosing and monitoring CRS, an adverse effect often associated with therapies like CAR-T cell treatments
Clinical Management of Cytokine Release Syndrome in CAR-T Therapy
Cytokine Release Syndrome (CRS) is a major concern in CAR-T therapy How do you approach the grading and management of CRS? Which strategies have you found most effective for reducing the severity of CRS? Are there notable differences in CRS management protocols between ide-cel and cilta-cel?
Refining CRS and ICANS Management in CAR T-Cell Therapy: Understanding . . .
CRS and ICANS are significant toxicities in CAR T-cell therapy, with refined diagnostic criteria improving management CRS management involves early intervention with tocilizumab and corticosteroids, while ICANS relies on corticosteroids