Levetiracetam
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Lack of efficacy: 2 case reports In a case series* , 2 women aged 58–61 years were described, who exhibited lack of efficacy during treatment with levetiracetam for CAR-T-cell related encephalopathy syndrome (CRES) [dosages and routes not stated]. Case 2: The 58-year-old woman started receiving unspecified CAR-T-cell therapy for diffuse large B-cell lymphoma. One week following the initiation of the therapy, she developed cytokine release syndrome (CRS). Thereafter, she CRES secondary to the CART-cell therapy. Consequently, she was treated with levetiracetam with no significant response (lack of efficacy). Transient response was noted with lorazepam. Further, upon addition of lacosamide to the treatment, generalised periodic discharges (GPDs) became less prominent. Generalised rhythmic delta activity (GRDA) with generalised sharp waves remained persistent with stimulation or arousal. Dexamethasone dose was increased. After 72-hours, the discharges became less frequent. Subsequently, clinical and electrographic improvement was achieved. Case 3: The 61-year-old woman started receiving unspecified CAR-T-cell therapies for diffuse large B-cell lymphoma. One week following the initiation of the therapy, she was diagnosed with CRES and CRS secondary to the CAR-T-cell therapy. She was treated with levetiracetam with no response (lack of efficacy). Transient improvement was noted with lorazepam. Dexamethasone dose was increased. After 48-hours, the discharges became less frequent. Subsequently, clinical and electrographic improvement was achieved. * Country of occurrence, reporter country and primary source country not stated, Author contact details not available.Presented at American Clinical Neurophysiology Society (ACNS) annual meeting 2020 Akkineni K, et al. Eeg findings in patients on car-t therapy with car-t-cell related encephalopathy syndrome (CRES): A case series. Journal of Clinical Neurophysiology 37: 803507549 317-318 (plus poster) abstr. F21, No. 4, Jul 2020. Available from: URL: http://doi.org/10.1097/WNP.0000000000000698 [abstract]
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Reactions 17 Oct 2020 No. 1826
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