CAR-T 细胞治疗期间及 ICANS 发生时细胞外囊泡的动态特征

Inclusion Criteria:

* Patient aged over 18,
* Patient for whom CAR-T treatment is indicated,
* Patient affiliated to a social security system
* Patient who give his consent to participate in the study.

Exclusion Criteria:

* Pregnant or breastfeeding woman,
* Patient unable to understand informed consent,
* Patient under legal protection.

主要终点：Endothelial EVs quantification (EVs/mL) · Quantification by Nano Tracking Analysis of endothelial EVs as a function of time before and after treatment with CAR-T cells according to ICANS grade. · Days -7, 0, 1, 2, 5, 8, 15, 30 and 60；Endothelial EVs characterization (immunophenotyping) · Characterization by Nano Tracking Analysis (immunophenotyping by size) of endothelial EVs as a function of time before and after treatment with CAR-T cells according to ICANS grade. · Days -7, 0, 1, 2, 5, 8, 15, 30 and 60
次要终点：Other EV subtypes quantification (EV subtype/mL)；Other EV subtypes characterization (immunophenotyping)；EVS quantification according to the presence of an ICANS versus no ICANS (EV/mL)；EVs characterization according to the presence of an ICANS versus no ICANS (immunophenotyping)；EVs quantification according to levels of cytokines (EVs/mL)；EVs characterization according to levels of cytokines；EVs quantification in cerebrospinal fluid (EVs/mL)；EVs characterization in cerebrosinalfluid.

• CAR T cell treatment · EXPERIMENTAL · Major patients for whom CAR-T treatment is indicated.

Immune effector Cell-Associated Neurotoxicity Syndrome (ICANS) is a common and serious neurological complication associated with the use of CAR-T cells. The mechanisms involved are still poorly understood but studies suggest that inflammation during treatment leads to an increase in the permeability of the barrier between the brain and the blood vessels and the emission of extracellular vesicles (EVs) circulating between the brain and the blood vessels. EVs are biological particles that play an important role in cellular communication and the modulation of several physiological processes. The VESICANS study aims to characterize the EVs released before and during CAR-T cells treatment and upon the occurrence of ICANS, using flow cytometry, electron microscopy, Nanoparticle Tracking Analysis associated with MRI assessment of the barrier between the brain and blood. This study will ultimately contribute to facilitating the prevention and treatment of this toxicity which affects the prognosis of patients.