Journal Article

DZNE-2026-00759

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Evidence for early, clinically silent medial temporal lobe inflammation after CAR-T cell therapy.

Dubai, M. A. ; Rebello, M. V. ; Neumann, K. ; Berisha, M. ; Katsaros, D. ; Haage, T. R. ; Walther, D. ; Kaufmann, J. ; Fricke, S. ; Uher, D. ; Speck, O.DZNE* ; Engel, J. ; Meuth, S. G. ; Melekh, B. ; Behme, D. ; Mattern, H.DZNE* ; Henneicke, S.DZNE* ; Schreiber, S.DZNE* ; Mougiakakos, D.

2026
Elsevier Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.ejca.2026.116925

Abstract: Immune effector cell-associated neurotoxicity syndrome (ICANS) is the most frequent neurological complication following chimeric antigen receptor (CAR)-T cell therapy. Long-term cognitive effects remain controversial, even in the absence of clinical neurotoxicity. CAR-T cell-associated neurotoxicity often involves the medial temporal lobe (MTL), yet conventional structural magnetic resonance imaging (MRI) frequently remains normal. There is a need for markers of subclinical neurotoxicity that may predict long-term cognitive outcomes.Therefore, we established an imaging protocol integrating 3 Tesla (T) and 7 T perfusion and functional connectivity MRI of the MTL in patients receiving CAR-T cells for B cell malignancies. Longitudinal data from four patients is presented here.Two of the four patients developed ICANS (grade 1 and grade 3), and these patients also experienced mild cytokine release syndrome (CRS, grade 1). No structural abnormalities of the MTL were detected at baseline or during follow-up. CAR-T cell expansion varied markedly between patients. Regardless of ICANS, CRS, or CAR-T cell expansion, patients showed increased MTL perfusion and functional connectivity, most prominently at days 10-14.These data suggest an early, clinically silent inflammatory response in the MTL with potential implications for long-term cognitive function, which requires further investigation.

Keyword(s): CAR-T cell therapy ; ICANS ; MRI ; Neurotoxicity ; Toxicity

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Contributing Institute(s):

1. Linking Imaging Projects (AG Speck)
2. Mixed Cerebral Pathologies and Cognitive Aging (AG Schreiber)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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