Chimeric Antigen Receptor (CAR) T-cell Therapy in Neurological Disorders

prednisone taper over multiple weeks.Mental status improved within three days of treatment.Repeat MRI showed resolution of leptomeningeal enhancement.Repeat exam four weeks following presentation showed improved cognition (Kokmen STM 35/38) and known peripheral neuropathy.Repeat CSF showed 35 nucleated cells/ mcl.CSF cytokine testing at nadir showed very high IL6, IL10, CXCL10, CXCL9, CXCL13, IFN g and to a lesser extent IL1b, GM-CSF, BAFF and CXCL8 that improved on repeat CSF. ConclusionsThis case demonstrates an unusually significant CSF pleocytosis in the context of an immune-checkpoint inhibitor-associated meningoencephalitis.The cytokine signature and the cytology data suggest a predominant T-cell mediated inflammatory process (mainly CD4+ T-cells) responsive to immunotherapy.Study Supported By: N/A.Disclosure: Dr. Hasan