CRS and ICANS in CAR T-cell therapy for large B-cell lymphoma

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Chimeric antigen receptor T-cell (CAR T-cell) therapy has become an established treatment option for relapsed or refractory large B-cell lymphoma, offering durable remission in some previously incurable cases. However, the effective management of immune-mediated toxicities, particularly cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), remains critical to ensure safety. Treatment algorithms have been proposed based on the American Society for Transplantation and Cellular Therapy consensus grading system by the Joint Accreditation Committee of the International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation, as well as the National Comprehensive Cancer Network guidelines. Recently, early intervention to ensure that CAR T-cell therapy is performed safely has also been proposed. This review provides an update and overview of the treatment strategies for CRS and ICANS in CAR T-cell therapy for malignant lymphoma.