Mitigation domain	Most defensible current use	Practical caveat	Supporting included studies
Early steroid escalation	When neurologic decline is clinically meaningful, and alternative diagnoses have been addressed	Best used as part of a workflow that includes neurology input, severity grading, and seizure exclusion when appropriate	Consensus and review-level guidance (1–3)
Antiseizure therapy	Treat witnessed or electrographic seizures; consider a lower threshold in clearly high-risk severe cases.	The current included evidence does not support routine prophylaxis for all patients	EEG series and review-level guidance (2, 3, 9, 10, 25)
Tocilizumab prophylaxis in bispecific programs	Reasonable program-level strategy where step-up dosing logistics and prior institutional experience support it	Needs integration with local pathways and continued neurologic vigilance because low event rates do not equal zero risk	Real-world 119-patient cohort with low CRS and ICANS rates (13)
ICU transfer/continuous EEG	Severe encephalopathy, coma, recurrent seizure concern, hemodynamic instability, or multi-organ toxicity	Triggered escalation is more efficient than blanket ICU use	Consensus workflow literature and adult EEG data (1, 9)
Late-syndrome surveillance and rescue	Movement disorder or executive decline after BCMA-directed therapy should prompt renewed neurologic evaluation; rescue strategies may differ from classical early ICANS	Delayed syndromes may not respond like typical dopaminergic disease; case literature supports alternative immunomodulatory approaches in selected settings.	Cilta-cel MNT analyses and delayed rescue literature (17–20)