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[CARs, CRS and neurotoxicity: severe complications after administration of immunotherapy : Essentials for intensivists].

BACKGROUND: The development of chimeric antigen receptor (CAR) T‑cells has shown promising results in relapsed/refractory B‑cell acute lymphoblastic leukemia/lymphoma (B-ALL) and diffuse large cell B‑cell lymphoma. Complications, especially cytokine release syndrome (CRS) and CAR T‑cell related encephalopathy syndrome (CRES), can be life threatening. The management of both plays a key role in CAR T‑cell therapy.

OBJECTIVES: Diagnosis, clinical presentation and development of complications in the treatment with CAR T‑cells.

MATERIALS AND METHODS: Summary of incidence, mortality and treatment of severe complications after administration of CAR T‑cells referring to current studies and therapy recommendations.

RESULTS: Complications after administration of CAR T‑cells, especially CRS and CRES, can be life threatening. The timely identification of side effects and their appropriate treatment usually leads to complete recovery.

CONCLUSIONS: Using a therapy algorithm in the treatment with CAR T‑cells allows safe management of toxicities and can be helpful in recognizing them in time.

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