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Chimeric antigen receptor T-cell neuropsychiatric toxicity in acute lymphoblastic leukemia

  • Vasthie Prudent (a1) (a2) and William S. Breitbart (a1)


Chimeric antigen receptor T cells are used in the treatment of B-cell leukemias. Common chimeric antigen receptor T-cell toxicities can range from mild flu-like symptoms, such as fever and myalgia, to a more striking neuropsychiatric toxicity that can present as discrete neurological symptoms and delirium. We report here two cases of chimeric antigen receptor T-cell neuropsychiatric toxicity, one who presented as a mild delirium and aphasia that resolved without intervention, and one who presented with delirium, seizures, and respiratory insufficiency requiring intensive treatment. The current literature on the treatment and proposed mechanisms of this clinically challenging chimeric antigen receptor T-cell complication is also presented.


Corresponding author

Address correspondence and reprint requests to: Vasthie Prudent, 1475 NW 12th Avenue, University of Miami Miller School of Medicine, Suite C021, Locator code D21, Miami, Florida 33136. E-mail:


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Chimeric antigen receptor T-cell neuropsychiatric toxicity in acute lymphoblastic leukemia

  • Vasthie Prudent (a1) (a2) and William S. Breitbart (a1)


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