Neuroanaesthesia & neurocritical care
The clinical picture of ICANS after CAR-T cell therapy in critically ill patients: A retrospective clustering analysis of a multicentre multinational cohort study
Authors' conclusion
This study provides a detailed characterization of ICANS, highlighting distinct patterns of neurological symptoms.
Study context
- Population
- CAR T-cell recipients for hematological malignancies admitted to ICU who developed ICANS100 with ICANS
- Participants
- 241 recipients
- Comparison
- Cluster 1 vs Cluster 2 vs Cluster 3 vs Cluster 4
Methodological detailsretrospective clustering analysis, pre-planned substudy, international, hierarchical clustering analysis
- Retrospective clustering analysis
- Pre-planned substudy
- International
- Hierarchical clustering analysis
Primary result
As reported in the abstract
Neurological symptom clusters (hierarchical clustering)
| Outcome | Cluster 1 | Cluster 2 | Cluster 3 | Cluster 4 |
|---|---|---|---|---|
| Confusion | 11.2% | 78.9% | — not stated in the abstract | — not stated in the abstract |
| Drowsiness | — not stated in the abstract | 47.4% | — not stated in the abstract | — not stated in the abstract |
| Seizures | — not stated in the abstract | 42.1% | — not stated in the abstract | — not stated in the abstract |
| Coma | — not stated in the abstract | 21.1% | — not stated in the abstract | — not stated in the abstract |
| Tremor | — not stated in the abstract | — not stated in the abstract | 75% | — not stated in the abstract |
| Attention deficit | — not stated in the abstract | — not stated in the abstract | 37.5% | — not stated in the abstract |
| Aphasia | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 70.3% |
| Dysgraphia | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 37.8% |
| Disorientation | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 27% |
— not stated in the abstract
- Four distinct clusters with minimal symptom overlap; clustering statistically significant
- P < 0.001
Further findings
ICANS incidence
- ICANS identified
- 100 patients (41.5%)
- Median age
- 61 years
- Non-Hodgkin lymphoma
- 93%
Severe ICANS
- Severe ICANS occurred
- 38%
- Associated with longer duration of symptoms
- P = 0.02
Duration of neurological symptoms
- Whole cohort, median 5 days
- IQR 1-8
- Isolated ICANS, longer: median 16 days (IQR 11-24)
- P = 0.001
Original publication
The clinical picture of ICANS after CAR-T cell therapy in critically ill patients: A retrospective clustering analysis of a multicentre multinational cohort study. Ann Intensive Care. Published 25 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →