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ReplyLETTER

Reply:

H.A. Valand, F. Huda and R.K. Tu
American Journal of Neuroradiology October 2019, 40 (10) E53; DOI: https://doi.org/10.3174/ajnr.A6231
H.A. Valand
aAmerican University of Integrative Sciences Brampton, Ontario, Canada
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F. Huda
aAmerican University of Integrative Sciences Brampton, Ontario, Canada
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R.K. Tu
aAmerican University of Integrative Sciences Brampton, Ontario, Canada
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Thank you for providing an opportunity to respond to the 2 letters, the first by Drs Gust and Ishak and the second by Dr Nabavizadeh. Our article focused on imaging findings of neurotoxicity of chimeric antigen receptor T-cell (CAR-T) therapy, an important new therapy for B-cell malignancies. As collective experience increases, so will reporting and understanding the imaging findings. Most published imaging findings of toxicity are in nonimaging journals. Adult neurotoxicity imaging findings were reported in Cancer Discovery in December 2017 by Gust et al;1 Cancer Discovery in June 2018 by Santomasso et al;2 and CNS Drugs in November 2018.3 Subsequent to our May 2019 publication in the American Journal of Neuroradiology, Annals of Neurology published findings by Gust et al4 in children and young adults in July 2019 and recently Brain, in May 2019, reported findings of acute stroke and hemorrhage.5 As imaging findings of neurotoxicity are identified and published, neuroradiologists and the imaging community will benefit from continued interest and publication in this area.

References

  1. 1.↵
    1. Gust J,
    2. Hay KA,
    3. Hanafi L-A, et al
    . Endothelial activation and blood-brain barrier disruption in neurotoxicity after adoptive immunotherapy with CD19 CAR-T cells. Cancer Discov 2017;7:1404–19 doi:10.1158/2159-8290.CD-17-0698 pmid:29025771
    Abstract/FREE Full Text
  2. 2.↵
    1. Santomasso BD,
    2. Park JH,
    3. Salloum D, et al
    . Clinical and biological correlates of neurotoxicity associated with CAR T-cell therapy in patients with B-cell acute lymphoblastic leukemia. Cancer Discov 2018;8:958–71 doi:10.1158/2159-8290.CD-17-1319 pmid:29880584
    Abstract/FREE Full Text
  3. 3.↵
    1. Gust J,
    2. Taraseviciute A,
    3. Turtle CJ
    . Neurotoxicity sssociated with CD19-targeted CAR-T cell therapies. CNS Drugs 2018;32:1091–101 doi:10.1007/s40263-018-0582-9 pmid:30387077
    CrossRefPubMed
  4. 4.↵
    1. Gust J,
    2. Finney OC,
    3. Li D, et al
    . Glial injury in neurotoxicity after pediatric CD19-directed CAR-T cell therapy. Ann Neurol 2019;86:42–54 doi:10.1002/ana.25502 pmid:31074527
    CrossRefPubMed
  5. 5.↵
    1. Rubin DB,
    2. Danish HH,
    3. Ali AB, et al
    . Neurological toxicities associated with chimeric antigen receptor T-cell therapy. Brain 2019;142:1334–48 doi:10.1093/brain/awz053 pmid:30891590
    CrossRefPubMed
  • © 2019 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 40 (10)
American Journal of Neuroradiology
Vol. 40, Issue 10
1 Oct 2019
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H.A. Valand, F. Huda, R.K. Tu
American Journal of Neuroradiology Oct 2019, 40 (10) E53; DOI: 10.3174/ajnr.A6231

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H.A. Valand, F. Huda, R.K. Tu
American Journal of Neuroradiology Oct 2019, 40 (10) E53; DOI: 10.3174/ajnr.A6231
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