TOXICITIES ASSOCIATED WITH IMMUNOTHERAPY IN CHILDREN WITH B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA AND MODERN APPROACHES TO THEIR MANAGEMENT
Keywords:
B-cell acute lymphoblastic leukemia (B-ALL), immunotherapy, pediatric oncohematology, cytokine release syndrome (CRS), ICANS, blinatumomab, CAR-T cell therapy, toxicity, neurotoxicity, treatment algorithms.Abstract
This article analyzes the clinical efficacy of modern immunotherapeutic agents used in the treatment of B-cell acute lymphoblastic leukemia (B-ALL) in pediatric oncohematology, including blinatumomab, inotuzumab ozogamicin, and CAR-T cell therapy, as well as the specific adverse effects associated with these treatments. The study discusses the pathogenesis and clinical manifestations of cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and non-hematologic toxicities observed during immunotherapy. The authors present international standards and modern algorithms for the management of these complications, including their early diagnosis, severity assessment (grading), and the use of tocilizumab, corticosteroids, and other supportive therapies. The article serves as an important practical guide for pediatric oncologists, hematologists, and intensivists in ensuring the safety of immunotherapy.
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