Biomedical Research

Chimeric Antigen Receptor (CAR) T-cell therapy is the modern tool in the armamentarium of hematologists to treat patients with several hematological malignancies. Although very effective for advanced disease, it comes with its own limitations and adverse events. We present a unique case of hyperacute acute cerebral edema following (CAR) T-cell therapy in a young male who was treated for B-cell acute lymphoblastic leukemia. Shortly after therapy initiation, the patient developed seizures and rapid deterioration in consciousness. After initiation of treatment of seizures, and medical stabilization, imaging revealed diffuse cerebral edema on brain Magnetic Resonance Imaging (MRI). Subsequent brain CT 10-hours later confirmed progressive brain damage. The patient was given maximal medical treatment for acute cerebral edema, however, he succumbed to this acute adverse event of (CAR) T- cell therapy. This case highlights the importance of recognizing the hyperacute presentation of severe adverse events associated with (CAR) T-cell therapy. It also highlights the high risks associated with this unique treatment. Enhancing patient safety and treatment outcomes is highly recommended through the review of infusion protocols and the implementation of preventive measures.

Author(s): Awadh M. Alahmari, Ismail A. Khatri
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