• Cristina Gutierrez, Colleen McEvoy, Elena Mead, R Scott Stephens, Laveena Munshi, Michael E Detsky, Stephen M Pastores, and Joseph L Nates.
• Department of Critical Care, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
• Crit. Care Med. 2018 Sep 1; 46 (9): 1402-1410.

ObjectivesChimeric antigen receptor T-cell therapy, a type of immune effector therapy for cancer, has demonstrated encouraging results in clinical trials for the treatment of patients with refractory hematologic malignancies. Nevertheless, there are toxicities specific to these treatments that, if not recognized and treated appropriately, can lead to multiple organ failure and death. This article is a comprehensive review of the available literature and provides, from a critical care perspective, recommendations by experienced intensivists in the care of critically ill adult chimeric antigen receptor T-cell patients.Data SourcesPubMed and Medline search of articles published from 2006 to date.Study SelectionClinical studies, reviews, or guidelines were selected and reviewed by the authors.Data ExtractionNot available.Data SynthesisNot available.ConclusionsUntil modifications in chimeric antigen receptor T-cell therapy decrease their toxicities, the intensivist will play a leading role in the management of critically ill chimeric antigen receptor T-cell patients. As this novel immunotherapeutic approach becomes widely available, all critical care clinicians need to be familiar with the recognition and management of complications associated with this treatment.

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