Leon Kaulen: The First Comprehensive Characterization of TIAN Arising in CNS Lymphoma
Leon Kaulen, Clinician Scientist at German Cancer Research Center, shared a post on LinkedIn:
“Excited to share our study on Tumor Inflammation Associated Neurotoxicity (TIAN) in CNS Lymphoma (CNSL) treated with CD19-directed CAR T-cell Therapy, just published in Blood, American Society of Hematology.
TIAN represents a recently defined on-tumor, on-target neurotoxicity syndrome, distinct from ICANS, which may result in elevated intracranial pressure with fatality risk.
In our study, we provide the first comprehensive characterization of TIAN arising in CNSL treated with CD19-CAR based on a large cohort of patients treated with CAR-T cells for CNSL.
- TIAN occurred early after CD19-CAR infusion (median 3.5 days).
- Larger tumor volume (>3.4cm3) at baseline allowed the identification of patients at risk for TIAN (sensitivity: 80.5%; specificity: 87.5%)
- TIAN was associated with improved overall response rates and progression-free survival on multivariate analysis.
- Autopsy findings allowed first and unique histopathological insights into this newly defined neurotoxicity syndrome: It revealed localized neurotoxicity (dense macrophage infiltrates, reactive gliosis, white matter loss) corresponding to the lesion on MRI.
Grateful for support and mentorship from Jorg Dietrich and Wolfgang Prof Wick.
Thankful to the entire Mass General Cancer Center team involved in this work.”
Title: Clinical presentation, management, and outcome of TIAN in CNS lymphoma treated with CD19-CAR T-cell Therapy
Authors: Leon D. Kaulen, Maria Martinez-Lage, Jeremy S. Abramson, Philipp Karschnia, Sofia Doubrovinskaia, Ganesh M. Shankar, Bryan D. Choi, Christopher Michael Ramundo, Felix Ehret, Jeffrey A. Barnes, Areej El-Jawahri, Ephraim Hochberg, P. Connor Johnson, Jacob D Soumerai, Scott R. Plotkin, Tracy T Batchelor, Wolfgang Wick, Marcela V. Maus, Yi-Bin Chen, Matthew J. Frigault, Jorg Dietrich
Read the Full Article on Blood
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