Figure 2 Three-step approach to the assessment and management

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Presentation transcript:

Figure 2 Three-step approach to the assessment and management of acute toxicities associated with chimeric antigen receptor (CAR)-T-cell therapy Figure 2 | Three-step approach to the assessment and management of acute toxicities associated with chimeric antigen receptor (CAR)-T-cell therapy. Step 1: the patient's clinical and biological symptoms should be monitored to determine the nature of the CAR-T-cell-related toxicity, in order to diagnose cytokine-release syndrome (CRS), CAR-T-cell-related encephalopathy syndrome (CRES), and haemophagocytic lymphohistiocytosis/macrophage-activation syndrome (HLH/MAS; Box 5). Step 2: the severity of CRS, CRES, and HLH/MAS should be graded using the criteria provided in Table 2, Table 4, and the Common Terminology Criteria for Adverse Events, version 4.03 (CTCAE)43, respectively. Step 3: the toxicities should be treated according to the management algorithms we have provided for CRS (Table 3), CRES (Box 2), and HLH/MAS (Fig. 3). CARTOX-10, CAR-T-cell-therapy-associated toxicity 10-point neurological assessment; CSF, cerebrospinal fluid; ICP, intracranial pressure. Neelapu, S. S. et al. (2017) Chimeric antigen receptor T‑cell therapy — assessment and management of toxicities Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2017.148