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 Cytokine release syndrome (CRS) and neurological toxicity with cellular therapy:

Cytokine release syndrome (CRS) and neurological toxicity, including fatal or life-threatening reactions, have occurred in patients receiving this treatment. Do not administer cellular therapy to patients with active infection or inflammatory disorders. Treat severe or life threatening CRS with tocilizumab as per ID 3500 CRS associated with CAR T-cell therapy and neurological toxicity as per ID 3834 Neurotoxicity associated with CAR T-cell therapy or as per local institutional guidelines.

This treatment should only be carried out in an institution approved to administer cellular therapies due to the intense monitoring and support required.

Refer to the Medical Services Advisory Centre (MSAC) for guidance on patients to consider for cellular therapy. Link to MSAC website.

Patients with lymphoma should be considered for inclusion into clinical trials. Link to ALLG websiteANZCTR website and Lymphoma Australia website.

This protocol is based on limited evidence; refer to the evidence section of this protocol for more information.

The ADDIKD guideline does not address dose adjustment for kidney dysfunction in stem cell mobilisation, bone marrow transplantation and cellular therapies. In these circumstances, the transplant team should be consulted if the patient has kidney dysfunction and is requiring one of the drugs referred to in ADDIKD as part of their treatment.

The information contained in this protocol is based on the highest level of available evidence and consensus of the eviQ reference committee regarding their views of currently accepted approaches to treatment. Any clinician (medical oncologist, haematologist, radiation oncologist, medical physicist, radiation therapist, pharmacist or nurse) seeking to apply or consult this protocol is expected to use independent clinical judgement in the context of individual clinical circumstances to determine any patient's care or treatment. While eviQ endeavours to link to reliable sources that provide accurate information, eviQ and the Cancer Institute NSW do not endorse or accept responsibility for the accuracy, currency, reliability or correctness of the content of linked external information sources. Use is subject to eviQ’s disclaimer available at www.eviQ.org.au

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The currency of this information is guaranteed only up until the date of printing, for any updates please check:

https://www.eviq.org.au/p/3839

29 Mar 2024