TY  - JOUR
AU  - Yan, Sijia
AU  - Ming, Xi
AU  - Wu, Jiaying
AU  - Zhu, Xiaojian
AU  - Zhou, Mi
AU  - Xiao, Yi
PY  - 2025
TI  - Fatal complication unveiled: analyzing intracerebral hemorrhage risk after CAR-T therapy in hematologic malignancies
JO  - Brain Hemorrhages
SN  - 2589-238X
SP  - 212
EP  - 219
VL  - 6
IS  - 5
AB  - ObjectiveChimeric antigen receptor T (CAR-T) cell therapy has demonstrated significant efficacy in the treatment of hematologic malignancies, yet it can lead to severe complications. Intracranial hemorrhage (ICH), although rare, is a particularly lethal outcome. Current research on the risk factors and underlying mechanisms of ICH post-CAR-T therapy remains limited.MethodsThis retrospective study analyzed 10 cases of ICH among 2255 patients who underwent CAR-T therapy at Tongji Hospital in Wuhan from January 2015 to December 2024. We collected data on baseline characteristics, CAR-T treatment parameters, inflammatory markers, coagulation function, and clinical outcomes.ResultsThe incidence of ICH was 0.44 %, with the median time to onset being 25 days following infusion. All affected patients exhibited thrombocytopenia, and 80 % experienced coagulopathy. Levels of C-reactive protein and Interleukin-6 were significantly elevated before and after treatment. The mortality rate was 90 %, with nine patients succumbing to respiratory and circulatory failure associated with ICH.ConclusionThe development of ICH after CAR-T therapy is strongly linked to thrombocytopenia, coagulopathy, and the inflammatory response triggered by cytokine release syndrome (CRS). Early identification and proactive management of high-risk patients could potentially improve outcomes. Further prospective studies are necessary to confirm risk prediction models and enhance therapeutic strategies.
UR  - https://doi.org/10.1016/j.hest.2025.07.007
DO  - 10.1016/j.hest.2025.07.007