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@ARTICLE{Vlker:285052,
      author       = {Völker, Lotta and Müller-Jensen, Leonie and Carl, Sophia
                      and Nay, Sandra and Möllenkamp, Thiemo Malte and
                      Schultze-Florey, Christian and Grote-Levi, Lea and
                      Jendretzky, Konstantin F and Konen, Franz Felix and
                      Könecke, Christian and Eder, Matthias and Panagiota,
                      Victoria and Heidel, Florian H and Bullinger, Lars and Damm,
                      Frederik and Frick, Mareike and Penack, Olaf and Ludwig,
                      Rebecca and Buß, Eric Anil and Boehmerle, Wolfgang and
                      Endres, Matthias and Gudi, Viktoria and Huehnchen, Petra and
                      Skripuletz, Thomas and Möhn, Nora},
      title        = {{T}he {B}erlin-{H}annover {ICANS} severity assessment-a
                      novel bedside test to evaluate {CAR} {T}-cell-associated
                      neurotoxicity.},
      journal      = {Frontiers in neurology},
      volume       = {17},
      issn         = {1664-2295},
      address      = {Lausanne},
      publisher    = {Frontiers Research Foundation},
      reportid     = {DZNE-2026-00176},
      pages        = {1726779},
      year         = {2026},
      abstract     = {Chimeric antigen receptor (CAR) T-cell therapy has
                      transformed the treatment of refractory hematological
                      malignancies but is frequently complicated by immune
                      effector cell-associated neurotoxicity syndrome (ICANS).
                      Early clinical recognition remains challenging, as the
                      commonly used Immune Effector Cell-Associated Encephalopathy
                      (ICE) score lacks sensitivity for subtle deficits.In this
                      prospective bicentric study, 100 patients treated with CAR
                      T-cells at Hannover Medical School and Charité -
                      Universitätsmedizin Berlin underwent systematic
                      neurological assessments using both ICE and the newly
                      developed Berlin-Hannover ICANS Severity Assessment (BHISA).
                      Examinations were performed at baseline prior to CAR T-cell
                      infusion, on day 6-7 (±1 day) post-infusion, and during
                      ICANS episodes. Data on the clinical course, other
                      toxicities, comorbidities, CAR T-cell products, and ICANS
                      treatment were collected.Thirty-seven patients $(37\%)$
                      developed ICANS, which was associated with preceding
                      cytokine release syndrome and specific CAR T-cell products.
                      While ICE scores clustered at maximum values both at
                      baseline and follow-up, BHISA showed a broader distribution
                      and higher sensitivity to subtle changes. Correlation
                      analyses confirmed agreement between ICE and BHISA, but
                      BHISA captured early cognitive decline more reliably.
                      Receiver operating characteristic analyses demonstrated
                      comparable diagnostic accuracy (BHISA: AUC = 0.783, ICE: AUC
                      = 0,777), with consistently higher sensitivity of BHISA at
                      matched specificity. (Specificity target = 0.7, BHISA
                      sensitivity = 0.743, ICE sensitivity = 0.571; Specificity
                      target = 0.8, BHISA sensitivity = 0.629, ICE sensitivity =
                      0.571).BHISA may provide a more sensitive and more
                      differentiated screening tool for ICANS than ICE by
                      incorporating additional cognitive and motor domains, while
                      remaining easy to use. This may enable earlier and more
                      nuanced detection of CAR T related neurotoxicity,
                      potentially improving patient monitoring across a
                      heterogeneous population.},
      keywords     = {BHISA (Other) / CAR T-cell therapy (Other) / ICANS (Other)
                      / ICE (Other) / screening tools (Other)},
      cin          = {AG Endres},
      ddc          = {610},
      cid          = {I:(DE-2719)1811005},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41648666},
      pmc          = {pmc:PMC12867840},
      doi          = {10.3389/fneur.2026.1726779},
      url          = {https://pub.dzne.de/record/285052},
}