Extended Data Table 1 |.
Detailed descriptions of patient characteristics and CirAE presentation, management and course
| ID | Age | Sex | Type of CirAE | Diagnostic Test | CirAE Grade (Based on ICI) | Onset (Days) | Presentation | Management | Steroid dose (Dex equivalent) | Duration of CirAE (Days) | Resolution of CirAE? |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cilta-cel#1 | 75 | M | Facial nerve palsy | Head CT: negative | 2 | 19 | Left sided facial droop at Day+19; bilateral facial droop at Day+69 | Multiple courses of oral steroids | 280 mg | 90 | Yes |
| Cilta-cel#2 | 67 | M | Inflammatory arthritis | Labs: RF, CCP, HLA-B27 negative; Knee X-ray: bilateral knee arthritis & effusion |
2 | 28 | Pain and swelling of fingers, elbows, shoulders, knees, ankles | Steroids, Hydroxychloroquine | 147 mg | 825 | Ongoing |
| Cilta-cel#3 | 53 | F | Parkinsonism | Head CT: negative | 2 | 39 | Shuffled gait, rigidity, and right-sided head tilt | Steroid IV, IVIG, trihexyphenidyl and amantadine | 1020 mg | 690 | Ongoing |
| Cilta-cel#4 | 74 | M | Facial nerve palsy | Clinical diagnosis | 2 | 31 | Left sided facial weakness | Oral steroids | 560 mg | 29 | Yes |
| Delayed ICANS | Brain MRI/CT: negative CSF: negative workup for infections or malignancy: CAR transgene detected |
2 | 57 | Altered mental status, slurred speech, disorientation | Steroid IV, IVIG | 7 | Yes | ||||
| Enterocolitis | Endoscopy: immune-mediated enterocolitis | 3 | 76 | Diarrhea, weight loss | TPN. Refractory to budesonide and oral steroid, responsive to infliximab | 765 | Yes | ||||
| Cilta-cel#5 | 66 | F | Enterocolitis | Endoscopy: immune-mediated enterocolitis | 2 | 154 | Diarrhea, nausea | Supportive (Loperamide, Cholestyramine) | 37.5 mg | 97 | Yes |
| Cilta-cel#6 | 65 | F | Enterocolitis | CRP and ESR negative | 1 | 25 | Diarrhea, nausea | Loperamide, supportive treatment | 150 mg | 152 | Yes |
| Cilta-cel#7 | 60 | F | Inflammatory arthritis | Clinical diagnosis; ESR elevated, SSA borderline |
2 | 7 | Bilateral arm, knee, and ankle pain with hand swelling and nocturnal stiffness. | Oral steroids, physical therapy | 32 mg | 127 | Yes |
| Cilta-cel#8 | 68 | M | Enterocolitis | Negative C.diff and enteric pathogen testing; Endoscopy: immune-mediated enterocolitis |
1 | 123 | Diarrhea, weight loss | Mesalamine, loperamide and budesonide | 0 mg | 178 | Yes |
| Cilta-cel#9 | 54 | M | Neuropathy (Parsonage-turner-like) | MRI brachial plexus: normal; EMG: neuropathy and myopathic findings |
2 | 9 | Bilateral shoulder and neck pain, left upper extremity weakness | Oral steroids, physical therapy, with improvement | 332 mg | 438 | Ongoing |
| Cilta-cel#10 | 67 | F | Enterocolitis | Endoscopy: Immune-mediated enterocolitis; no CMV or viral inclusion, C.diff negative | 4 | 86 | Severe diarrhea, abdominal pain, pneumatosis intestinalis | Loperamide, steroids, IVIG, ruxolitinib, TPN | 337 mg | 357 | No, CirAE related mortality |
| Cilta-cel#11 | 67 | F | Parkinsonism | Clinical diagnosis; Brain MRI: negative |
2 | 297 | Fatigue, hypokinesis | Carbidopa-Levodopa | 0 mg | 144 | Ongoing |
| Cilta-cel#12 | 70 | M | Parkinsonism | Clinical diagnosis; Brain MRI: unremarkable |
1 | 36 | Blunted affect, micrographia | Oral steroids | 116 mg | 66 | Yes |
| Cilta-cel#13 | 77 | F | Enterocolitis | Clinical diagnosis | 1 | 118 | Diarrhea | Loperamide, oral steroids | N/A | 223 | Ongoing |
| Cilta-cel#14 | 69 | M | Encephalopathy | MRI: bilateral thalamic diffusion restriction with peripheral enhancement CSF: elevated protein, CAR detected, JC virus positive (no clinical/ radiologic correlate) |
5 | 263 | Altered mental status, confusion, generalized fatigue, fever | Steroids IV | 937.5 mg | 18 | No, CirAE related mortality |
| Cilta-cel#15 | 65 | F | Parkinsonism | Head CT: negative; MRI: pachymeningeal thickening/enhancement. CSF: elevated protein, lymphocytic. CAR transcript detected. |
3 | 28 | Tremors, bradykinesia, altered mental status | Steroids, intrathecal chemotherapy, ruxolitinib | 585 mg | 225 | Ongoing |
| Cilta-cel#16 | 58 | F | Facial nerve palsy | MRI/CT brain: normal CSF: normal, CAR transcript detected |
2 | 17 | Right-sided facial droop at Day+17; left-sided facial droop at Day +44 | IVIG, Oral and IV steroids | 268 mg | 30 | Yes |
| Cilta-cel#17 | 67 | M | Facial nerve palsy | Head CT: Negative | 3 | 16 | Left sided facial droop/weakness | Oral, IV steroids | 108 mg | 210 | ongoing |
| Cilta-cel#18 | 67 | F | Facial nerve palsy | Clinical diagnosis | 2 | 18 | Left sided facial droop/weakness | Steroids oral | 200 mg | 90 | Yes |
| Cilta-cel#19 | 53 | F | Facial nerve palsy | Head CT: Negative | 2 | 20 | Right sided facial droop/weakness | Steroids oral | 78 mg | 33 | Yes |
| Cilta-cel#20 | 71 | M | Enterocolitis | Negative C.diff Bowel CT: Extensive pneumatosis, moderate pneumoperitoneum Endoscopy: immune-mediated colitis |
4 | 139 | Failure to thrive, Diarrhea, Severe Weight Loss | Steroids oral and IV, ruxolitinib, TPN | 460 mg | 45 | ongoing |
| Cilta-cel#21 | 61 | F | Optic neuritis | MRI: left optic neuritis/perineuritis; CSF: negative for infections/malignancy; CAR transgene detected |
5 | 62 | Headache, left eye swelling, ptosis, left field visual defects | Steroids oral and IV, tocilizumab without Improvement | 5100 mg | 108 | No, CirAE related mortality |
| Cilta-cel#22 | 55 | F | Facial nerve palsy | Head CT: Negative, CSF: CAR transcript detected | 2 | 22 | Left sided facial droop, ageusia, and headache | Steroids oral and IV | 444 mg | 135 | ongoing |
| Cilta-cel#23 | 77 | M | Parkinsonism | Clinical diagnosis | 3 | 57 | Unsteady gait apraxla, dizziness | Steroids IV, IVIG with improvement but not resolution | 562.5 mg | 99 | No, CirAE related mortality |
| Cilta-cel#24 | 74 | F | Facial nerve palsy | MRI: Right facial nerve enhancement (labyrinthine segment) | 2 | 42 | Right facial droop, blurry vision | Steroids oral | 73,5 mg | 50 | No, CirAE related mortality |
| Cilta-cel#25 | 75 | F | Facial nerve palsy | Head CT/Brain MRI: negative | 5 | 37 | Left facial weakness | Steroids IV without improvement | 232 mg | 31 | No, CirAE related mortality |
| Parkinsonism | Clinical diagnosis | 5 | 41 | Masked facies, upper extremity rigidity, and hypophonia. | Steroids IV, Carbidopa-Levodopa without Improvement | 27 | |||||
| Ida-cel#1 | 61 | F | Pneumonitis | Chest CT: bilateral lower lobe predominant, peri-bronchovascular groundglass opacities | 1 | 333 | Dyspnea | Supportive, temporary suspension of teclistamab | 0 mg | 27 | Yes |
| Ide-cel#2 | 82 | F | Pneumonitis | CT: diffuse bilateral ground-glass nodules; Bronchoscopy: negative for infection. | 3 | 361 | Cough. Hypoxemia, dyspnea | Steroids, ruxolitinib | 650 mg | 354 | Ongoing |