Dr Shannon Maude Discusses Side Effects of CAR T Therapies

Most primary side effects of CAR T therapies occur early on after treatment and resolve quickly, but there are some that require long-term monitoring, explained Shannon L. Maude, MD, PhD, of The Children's Hospital of Philadelphia.

What side effects of CAR T therapies are currently known?

Primary side effects of CAR T therapies occur early on after treatment and they’re related to the growth of the T cells and the actual activity of the T cells. So many patients will have fever and potentially progressing to more serious symptoms requiring hospital-level care and sometimes ICU-level care. Those symptoms typically resolve within the first week or sometimes within the first several weeks.

The main side effects of this therapy are within the first 28 days. But there’s lots of monitoring and potential for long-term side effects as well. Most patients are usually physically very well after the first month of treatment, but still require some focused monitoring for some of the on-target effects of CAR T cells, which involve B-cell aplasia. So, these patients, because of how CD19 CAR T cells work, will be depleted of their normal B cells, and that requires monitoring and replacement of the immunoglobulin long term.