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Table 2 Occurrence and characteristics of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in the 84 patients

From: Features and outcomes of patients admitted to the ICU for chimeric antigen receptor T cell-related toxicity: a French multicentre cohort

 

N (%) or

Median [IQR]

Patients with CRS

80 (95.2)

CRS grade (n = 80) a

1

33/80 (41.3)

2

29/80 (36.3)

3

15/80 (18.8)

4

3/80 (3.8)

Fever duration (days)

5 [3–7]

Time from fever to hypotension (days)

2 [1–3.75]

Time from fever onset to peak CRS severity (days)

5 [2–7]

CRS-associated complications

HLH without DIC

8/80 (10)

HLH and DIC

7/80 (8.8)

DIC without HLH

1/80 (1.3)

Patients with ICANS

46 (54.8)

ICANS grade (n = 46) a

1

9/46 (19.6)

2

8/46 (17.4)

3

15/46 (32.6)

4

14/46 (30.4)

Time to neurological symptoms resolution (days)

5 [3–8]

Time from CRS to ICANS (days) b

3 [2–4]

Time from neurological symptoms onset to peak ICANS severity (days)

1 [0–2]

Investigations for ICANS

Cerebral computed tomography

37/46 (80.4)

Basal ganglia hypodensities

2/37 (5.4)

Cerebral magnetic resonance imaging

29/46 (63)

Abnormal findings c

11/29 (37.9)

Lumbar puncture

36/49 (78.3)

Abnormal findings

25/36 (69.4)

Protein elevation ≥ 0.5 g/L

25/36 (69.4)

Pleocytosis ≥ 10/mm3

9/36 (25)

Electroencephalography

39/46 (84.8)

Abnormal findings

39/39 (100)

Non-specific encephalopathy

33/39 (84.6)

Seizures

6/39 (15.4)

Status epilepticus

3/39 (7.7)

  1. HLH Haemophagocytic lymphohistiocytosis, DIC disseminated intravascular coagulation
  2. a The maximum grade for each patient is reported
  3. b All patients with ICANS had CRS
  4. c Basal ganglia and/or white matter FLAIR hypersignals with inconsistent contrast enhancement