Language dysfunction-associated EEG findings in patients with CAR-T related neurotoxicity

• Main Authors: Andrew Cole, Elisaveta Sokolov, Philipp Karschnia, Reuben Benjamin, Robert D M Hadden, Robert C D Elwes, Lee Drummond, Devyani Amin, Vitor Paiva, Alex Pennisi, Aline Herlopian, Robin Sanderson, Shafquat Inam
• Format: Article
• Language: English
• Published: BMJ Publishing Group 2020-07-01
• Series: BMJ Neurology Open
• Online Access: https://neurologyopen.bmj.com/content/2/1/e000054.full

Aim We aimed to characterise language dysfunction and define electroencephalographic signatures after CAR-T cell therapy.Methods We reviewed the clinical presentation and EEG findings of 20 adult patients presenting with language dysfunction after CAR-T cell infusion. The cohort included a subset of patients treated with investigational CD19-directed CAR-T cells for non-Hodgkin’s lymphoma (n=17), acute lymphoblastic leukaemia (n=1), follicular lymphoma (n=1) and chronic lymphocytic leukaemia (n=1).Results Language dysfunction presented within 14 days of CAR-T cell infusion in 16 (84%) patients. Ten (50%) patients had mild word-finding difficulties and 10 (50%) had marked dysphasia with profound word-finding difficulties; the latter were all associated with generalised rhythmic delta activity or generalised periodic discharges on EEG.Conclusions Language dysfunction after CAR-T cell therapy is associated with generalised EEG abnormalities.