A novel case of presumed immunotherapy related inflammatory orbitopathy

Abstract

Chimeric antigen receptor T-cell (CAR T) therapy is an innovative form of cancer treatment, wherein a patient's own T cells are genetically modified to incorporate chimeric antigen receptors (CARs), enabling them to selectively identify and destroy cancer cells. This personalised T cell-based immunotherapy has shown promising results in treating hematological malignancies, such as certain types of relapsed or refractory leukaemia and lymphoma. However, it can also cause severe side effects, including cytokine release syndrome and neurologic toxicity, which need to be carefully managed. We present a case of a 42 year old man who developed severe periorbital inflammation as an adverse reaction to CAR T therapy for his systemic relapsed follicular lymphoma, which has not been reported in the literature before. This periorbital inflammation was presumed to be secondary to cytokine release syndrome, which is seen with CAR T treatment. He was treated with IV and oral corticosteroid, the periorbital swelling settled, and has not recurred to date.