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Research and new methods

Immune complications: CRS, ICANS and others

Powerful immunotherapy (CAR-T, bispecifics) can over-activate the immune system. These complications are often recognised early and treated.

Last updated: ~1 min read
A warm wave
Figure 1.A warm wave — Immune complications: CRS, ICANS and others

01Short answer

Cytokine release syndrome (CRS) causes fever, low blood pressure and breathlessness. ICANS causes confusion, difficulty writing or speaking, sleepiness and, rarely, seizures. Infections, long-lasting low blood counts and loss of B cells are also possible. So in the first weeks the patient stays near the treatment centre, and every new symptom is reported to the team straight away.

02Simple explanation

Fever: report it.

Confusion: urgent.

Stay near the centre.

Guard against infection.

03Scientific explanation

NCI: immunotherapy side effects can arise when the immune system acts on healthy tissues.

NCI: new treatments are tested step by step, from the laboratory to clinical trials; only those proven safe and beneficial become standard care.

04What happens in the body?

What to watch for

Fever, dizziness, confusion, changes in speech.

A nurse checking an older patient's temperature in a hospital bed
Figure 2.Monitoring: checking the temperature

Whom to call

The 24-hour number your team gave you.

The team
Figure 3.The team — Immune complications: CRS, ICANS and others

How to read the news

Research news brings hope, but not every advance suits everyone. Look at who it was tested in, at what phase and in how many people.

Talk to your doctor

Show your doctor what you have read; they will explain how it relates to your diagnosis and treatment. Do not change your treatment on your own.

05From research news to a conversation: four steps

Read, check, ask, decide together.

Read — From a trusted source.1ReadFrom a trusted source.
Check — Phase, participants, result.2CheckPhase, participants, result.
Ask — Show your doctor.3AskShow your doctor.
Decide — Together, without rushing.4DecideTogether, without rushing.
SourceA trusted site.
DoctorA personal explanation.
SafetyNot changing treatment yourself.

06Key points at a glance

TopicIn brief
What to watch forFever, dizziness, confusion, changes in speech.
Whom to callThe 24-hour number your team gave you.
How to read the newsResearch news brings hope, but not every advance suits everyone. Look at who it was tested in, at what phase and in how many people.
Talk to your doctorShow your doctor what you have read; they will explain how it relates to your diagnosis and treatment. Do not change your treatment on your own.

07Key terms

CRS
Cytokine release syndrome.
ICANS
Immune effector cell-associated neurotoxicity syndrome.
Clinical trial
Testing a new treatment with volunteers.
Evidence
A result confirmed by reliable research.

08Key points

  • Learn.
  • Ask your doctor.
  • Write it down.
  • Check the source.
  • Talk to your doctor.

09Frequently asked questions

If I have a fever, can I wait at home?

No, tell your team straight away.

Can these complications be treated?

Often yes, when recognised early.

Is this advance right for me?

Only your treating doctor can say, based on your diagnosis, stage and condition.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. If I have a fever, can I wait at home?

  2. Can these complications be treated?

  3. Is this advance right for me?

My questions

12Sources

  1. National Cancer Institute. Immunotherapy Side Effects
  2. National Cancer Institute. CAR T Cells: Engineering Immune Cells to Treat Cancer
  3. National Cancer Institute. Immunotherapy to Treat Cancer
  4. National Cancer Institute. What Are Clinical Trials?
  5. National Cancer Institute. Phases of Clinical Trials
  6. National Cancer Institute. Using Trusted Resources
  7. National Cancer Institute. NCI Dictionary of Cancer Terms: bispecific antibody
  8. National Cancer Institute. NCI Dictionary of Cancer Terms: T-cell receptor
  9. National Cancer Institute. NCI Dictionary of Cancer Terms: umbilical cord blood transplantation
  10. National Cancer Institute. NCI Dictionary of Cancer Terms: conditioning regimen
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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