Abstract Details

Title The Neurocognitive Impact of CAR T Cell Therapy in Hematological Cancers: A Systematic Review of Cognitive Function, Quality of Life, and Psychological Outcomes

Topic Neuro-oncology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-010

Objective To assess the long-term impact of CAR T-cell therapy on cognitive function, psychological health, and quality of life, focusing on patients developing ICANS.

Background CAR T-cell therapy has transformed how we treat blood cancers, giving patients lasting remissions that were previously impossible to achieve. However, patients developed concerning effects on brain function and mental health, especially in patients who develop immune effector cell-associated neurotoxicity syndrome (ICANS).

Design/Methods

A systematic search was made on PubMed, Embase, and Scopus databases following PRISMA guidelines to ensure thoroughness. Studies included randomized controlled trials, cohort studies, and observational studies that looked at cognitive function, psychological outcomes like anxiety, depression, and PTSD, as well as quality of life after CAR T-cell treatment. Study quality using the Cochrane Risk of Bias Tool for randomized trials and the Newcastle-Ottawa Scale for observational studies.

Results Our analysis included eighteen studies that met our criteria. We found that nearly half of CAR T-cell patients (up to 44%) experienced problems with thinking and memory, especially affecting their ability to remember things, pay attention, and make decisions. ICANS occurred in 25–70% of patients, with severe cases affecting 10–20% of recipients. Patients continued to have cognitive problems more than a year after treatment, particularly those who had experienced severe ICANS. Mental health challenges were also common, with 35% of patients developing anxiety and depression, while those with severe neurotoxicity sometimes developed PTSD. Although quality of life generally improved over time, patients with prolonged brain-related side effects took much longer to recover. EEG-based tools like the EICANS Score might help doctors predict who will develop severe ICANS.

Conclusions CAR T-cell therapy can cause lasting neurocognitive and psychological problems; therefore, improved systems are needed for ongoing cognitive assessment, standardized evaluation protocols, and targeted rehabilitation to optimize patient outcomes.

Authors/Disclosures
Ashvath A. Pillai, Student PRESENTER	Mr. Pillai has nothing to disclose.
Sai Kumar Reddy Pasya, MD, MBBS	Dr. Pasya has nothing to disclose.
Megha Tiwari, Assistant Professor	Miss Tiwari has nothing to disclose.
Sanjana Basavanagowda Patil, MBBS	Dr. Basavanagowda Patil has nothing to disclose.
Dhruv n. Gandhi, MD	Dr. Gandhi has nothing to disclose.
Aparna Nanda, Researcher	Ms. Nanda has nothing to disclose.
Sukriti Chugh	Ms. Chugh has nothing to disclose.
Sumit Chauhan, MBBS	Dr. Chauhan has nothing to disclose.
Shivangi Jha, MBBS, MPH	Dr. Jha has nothing to disclose.

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