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February 14, 2026HaematologicaOpen Access

ICANS mitigation in high-risk elderly patients treated with CD28 co-stimulatory anti-CD19 CAR-T cells using a standardization protocol: a pilot study

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Authors

GFGil FridbergOAOdelia AmitYSYehonathan Sherf

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Overview

Pilot study develops a standardized ICANS mitigation protocol for elderly patients receiving CD28 CAR-T, indicating improved management strategies.

Key Points

  • The study aims to develop a standardized protocol to mitigate ICANS in high-risk elderly patients treated with CD28-based CAR-T cells.
  • Single-arm prospective pilot study
  • Participants aged ≥75 years or ≥65 years with additional risk factors
  • Standardized protocol includes levetiracetam, thiamine, corticosteroids, and anakinra for ICANS
  • Endpoints measured were ICANS duration, refractoriness, and response.
  • 67% of patients experienced grade ≥3 ICANS, with a median ICANS duration of 4 days
  • 31% experienced refractory ICANS
  • No patient characteristics reliably predicted ICANS metrics except for LDH showing a trend
  • Cumulative steroid use was correlated with infections and non-relapse mortality.

Cite This Study

Fridberg et al. (2026) studied this question.

synapsesocial.com/papers/699011602ccff479cfe5809chttps://doi.org/10.3324/haematol.2025.288954
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