Article Text

Download PDFPDF
Ocular adverse events associated with chimeric antigen receptor T-cell therapy: a case series and review
  1. Aisha A Mumtaz1,
  2. Andrew Fischer1,
  3. Forat Lutfi2,
  4. Lisa R Matsumoto2,
  5. Djordje Atanackovic2,
  6. Elif T Kolanci1,
  7. Kim G Hankey2,
  8. Nancy M Hardy2,
  9. Jean A Yared2,
  10. Mehmet H Kocoglu2,
  11. Aaron P Rapoport2,
  12. Saurabh Dahiya2,
  13. Albert S Li3,
  14. Sarah Brem Sunshine1,2
  1. 1Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
  2. 2Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland - Baltimore, University of Maryland School of Medicine, Baltimore, Maryland, USA
  3. 3Vitreoretinal Consultants of New York, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
  1. Correspondence to Dr Sarah Brem Sunshine, Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA; ssunshine{at}som.umaryland.edu

Abstract

Background/aims Chimeric antigen receptor T-cell (CAR T) therapy has been shown to improve the remission rate and survival for patients with refractory haematological malignancies. The aim of this study is to describe ocular adverse effects associated with CAR T therapy in patients with haematological malignancies.

Methods This is a retrospective, single-institution, case series. Patients aged 18 years or older who received standard of care CAR T therapy for relapsed/refractory large B-cell lymphoma with a documented ophthalmic evaluation were included. The primary outcome was clinician ophthalmic examination findings.

Results A total of 66 patients received CAR T-cell therapy from February 2018 to October 2019 with 11 receiving an ophthalmic examination. Eleven patients (n=22 eyes) who received CAR T-cell therapy were included in review. The median time from CAR T-cell infusion date to ocular examination was 57.5 days. The median patient age at the time of examination was 60.5 years. Ten patients had subjective symptoms prompting ophthalmic examination. Two patients reported floaters and photopsias. One patient had worsening ocular graft-versus-host disease. Two patients were identified with possible reactivation of viral infections, including herpes zoster ophthalmicus and regressing acute retinal necrosis.

Conclusions The increasing use of CAR T therapy for malignancies underscores the importance of ophthalmologists and oncologists understanding the potential toxicities associated with its use, particularly ocular toxicities and when to refer for an ophthalmic examination.

  • immunology
  • neoplasia

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article.

View Full Text

Footnotes

  • Twitter @AlbertLiMD

  • ASL and SBS contributed equally.

  • Contributors SBS and ASL are responsible for the overall content and serve as guarantor of this work. ASL, AAM, APR, JAY, LRM, MHK, NMH, AF, SD had substantial contributions to the conception and design of the work. SBS, ASL, AAM, APR, JAY, LRM, MHK, NMH, AF, SD, FL, ETK, DA, KGH had substantial contributions to the acquisition, analysis and interpretation of the data for the work. SBS, ASL, AAM, SD had substantial contributions to the drafting of the work. SBS, ASL, AAM, APR, JAY, LRM, FL, ETK, MHK, NMH, KGH, AF, SD, DA had substantial contributions to the revising of the work for critically important intellectual content, final approval of the version to be published and have agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.