Acute myelopathy following chimeric antigen receptor (CAR) T cell therapy: an unusual diagnostic challenge - Takeaways - MDSpire
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Acute Myelopathy After CAR T-Cell Therapy: A Rare Diagnostic Dilemma

  • By

  • Antoine Bois

  • Corentin Provost

  • Justine Decroocq

  • Sarah Benghanem

  • October 8, 2026

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  • 1

    Acute extensive myelopathy is a rare, inadequately characterized form of CAR T-cell-associated neurotoxicity that may reflect spinal cord involvement in ICANS.

  • 2

    In profoundly immunocompromised patients with myelopathy, infectious causes—particularly viral infections—must be systematically excluded.

  • 3

    Negative cerebrospinal fluid cultures and multiplex PCR testing made an infectious cause unlikely in this patient.

  • 4

    The patient’s longitudinally extensive, nonenhancing spinal cord lesion was nonspecific, but concurrent brain lesions and exclusion of infection supported ICANS-associated myelopathy.

  • 5

    Severe encephalopathy can obscure the onset of spinal cord symptoms, and evidence is insufficient to establish a definitive treatment approach for ICANS-associated myelopathy.

Original Source(s)

Acute myelopathy following chimeric antigen receptor (CAR) T cell therapy: an unusual diagnostic challenge

  • by Antoine Bois, Corentin Provost, Justine Decroocq, Sarah Benghanem

  • October 8, 2026

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