Table 4.

Chimeric antigen receptor T cell–associated nephrotoxicity

Potential Nephrotoxicity
AKI
Prerenal AKI/acute tubular injury
Cytokine release syndrome with capillary leak and hypotension
Hemophagocytic lymphohistiocytosis with inflammation
Acute cardiac dysfunction with reduced cardiac output and hypotension
Intravascular volume depletion from fever, N/V, and diarrhea
Tumor lysis syndrome
Electrolyte disorders
Hypokalemia, hypophosphatemia, and hyponatremia
Prevention/treatment of toxicity
Chemotherapy to reduce tumor burden
Corticosteroids to reduce inflammatory response
Supportive care for hypotension with vasopressors, iv fluids, and oxygen
IL-6 blockade with tocilizumab for cytokine release syndrome and hemophagocytic lymphohistiocytosis

N/V, nausea and vomiting.