Psychiatric outcomes associated with Chimeric Antigen Receptor T-cell therapy: A Systematic Review

Simi M. Mathew MD, Nischit Baral MD, Calvin Ghimire MD, Tejaswi Vinjam MD, Joshua Christy MD, Ujwala Koduru MD, ArvindKunadi MD

ABSTRACT:

Background:

Chimeric antigen receptor (CAR) T-cell therapy is a therapeutic breakthrough treatment for selected hematological malignancies. Neuro-psychiatric complications have been reported with CAR-T-cell therapy. However, there is a paucity of data on the psychiatric effects of this therapy.

Methods:

We conducted a systematic review to highlight the psychiatric side effects of CAR-T-cell therapy. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to report findings.

Results

Table 1. Studies highlighting the important psychiatric side-effects associated with CAR-T-cell therapy

Abbreviations: FACT-Lym: Functional Assessment of Cancer Therapy- Lymphoma; SF-36: 36-Item Short Form Survey; Peds QL: Pediatric Quality of Life Inventory; EQ-5D: European Quality of Life Five Dimensions Questionnaire; ALL: acute lymphocytic leukemia; VAS: visual analog scale.

Conclusion:

Our findings suggest that cognitive impairment followed by mood symptoms was CAR-T-cell therapy's most common psychiatric side effect. There is a significant decline in the quality of life in these patients. Whether these side effects are due to the targeted therapy or other severe toxicities like cytokine release syndrome and neurotoxicity needs further exploration.

Keywords: CAR-T-Cell therapy, Systematic Review, Mood disorders, Psychiatric side-effects

No relevant conflicts of interest to declare.

Author notes

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Asterisk with author names denotes non-ASH members.

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