[CARs, CRS and neurotoxicity: severe complications after administration of immunotherapy : Essentials for intensivists].

BACKGROUND: The development of chimeric antigen receptor (CAR) Tcells has shown promising results in relapsed/refractory Bcell acute lymphoblastic leukemia/lymphoma (B-ALL) and diffuse large cell Bcell lymphoma. Complications, especially cytokine release syndrome (CRS) and CAR Tcell related encephalopathy syndrome (CRES), can be life threatening. The management of both plays a key role in CAR Tcell therapy. OBJECTIVES: Diagnosis, clinical presentation and development of complications in the treatment with CAR Tcells. MATERIALS AND METHODS: Summary of incidence, mortality and treatment of severe complications after administration of CAR Tcells referring to current studies and therapy recommendations. RESULTS: Complications after administration of CAR Tcells, especially CRS and CRES, can be life threatening. The timely identification of side effects and their appropriate treatment usually leads to complete recovery. CONCLUSIONS: Using a therapy algorithm in the treatment with CAR Tcells allows safe management of toxicities and can be helpful in recognizing them in time.