PT  - JOURNAL ARTICLE
AU  - MAI KUBOKI
AU  - YOSHIHIRO UMEZAWA
AU  - YOTARO MOTOMURA
AU  - KEIGO OKADA
AU  - AYAKO NOGAMI
AU  - TOSHIKAGE NAGAO
AU  - OSAMU MIURA
AU  - MASAHIDE YAMAMOTO
TI  - Severe Motor Weakness Due to Disturbance in Peripheral Nerves Following Tisagenlecleucel Treatment
AID  - 10.21873/invivo.12640
DP  - 2021 Nov 01
TA  - In Vivo
PG  - 3407--3411
VI  - 35
IP  - 6
4099  - http://iv.iiarjournals.org/content/35/6/3407.short
4100  - http://iv.iiarjournals.org/content/35/6/3407.full
SO  - In Vivo2021 Nov 01; 35
AB  - Background: Neurotoxicity is one of the dangerous complications of chimeric antigen receptor (CAR) T-cell therapy, while its pathophysiology remains to be fully understood. Motor weakness not associated with central nervous system (CNS) toxicity has rarely been reported after CAR T-cell therapy. Case Report: A 42-year-old female with a refractory diffuse large B-cell lymphoma received tisagenlecleucel (tisa-cel) and developed cytokine release syndrome (CRS) on day 3. She was treated with tocilizumab and methylprednisolone, which resolved CRS promptly. On day 7, motor weakness in lower extremities appeared, and she gradually became unable to walk without showing any other symptoms attributed to CNS disturbances. Whereas dexamethasone and tocilizumab were ineffective, neuropathy improved after high dose chemotherapy followed by autologous stem cell transplantation. Nerve conduction study (NCS) in lower extremities showed a decline in compound muscle action potential amplitude along with worsening of motor weakness, which was restored after improvement of symptoms. Based on symptoms and NCS, her motor weakness was thought to be due to disturbance in peripheral nerves. Conclusion: This study reports a patient who developed severe motor weakness due to disturbance in peripheral nerves after tisa-cel therapy. Neurotoxicity of non-CNS origin should also be noted in CAR T-cell therapy.