Nursing Considerations for CAR T-Cell Therapy: Management of Cytokine Release Syndrome and Immune Effector Cell–Associated Neurotoxicity Syndrome

BACKGROUND: Chimeric antigen receptor (CAR) T-cell therapy is a promising treatment for certain hematologic malignancies, but many nurses are not trained in caring for two common side effects, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). OBJECTIVES: This article provides foundational knowledge of CRS and ICANS, including the oncology nurse's role in toxicity monitoring, care coordination, and patient education. METHODS: To support safe, evidence-based CAR T-cell therapy administration, this article discusses grading guidelines, nursing assessments, interventions, and education strategies for CRS and ICANS. FINDINGS: Nurses serve a key role in mitigating CRS and ICANS through early recognition, continuous monitoring, therapeutic intervention, and patient and caregiver education. Using standardized protocols, frequently monitoring vital signs, and performing neurologic assessments optimize patient safety and outcomes.