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During Treatment

T-cell engaging antibodies (Bispecific Antibody Therapy), can cause Cytokine Release Syndrome (CRS). It might also cause neurologic toxicity including Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS). These are very serious health issues that can lead to serious harm.

Grand River Regional Cancer Centre Nurse Navigator

If you have ANY of the symptoms below call the Nurse Navigator.

Monday – Friday from 8am – 4pm

226-750-9099

CareChart Digital Health

If ANY of these symptoms happen after 4pm, on a weekend, or a holiday, call an oncology nurse at CareChart Digital Health.

1-877-681-3057

You are at highest risk of a reaction for 48 hours after your treatment. Check your temperature every 4 hours during this time and watch for the symptoms listed below:

In case of emergency go straight to an Emergency Department near you.

Symptoms of Cytokine Release Syndrome (a serious immune reaction)

  • A fever of 38.0°C (100.4°F) or higher (even if this only happens once) that lasts for more than 1 hour. Check your temperature every 4 hours. You should check more often if you are feeling unwell.
  • Chills
  • Shortness of breath
  • Flu-like symptoms (headache & muscle aches)
  • Feeling confused or restless
  • Nausea or vomiting (feeling sick to your stomach)
  • Low blood pressure (feeling dizzy, fast heart rate)

Symptoms of ICANS (neurologic problems)

  • Headache
  • Trouble writing or reading
  • Trouble speaking or understanding words
  • Trouble staying awake (drowsiness)
  • Agitation
  • Problems walking or loss of balance
  • Shaking (tremors or seizures)
  • Feeling confused or seeing things
  • Feeling “pins and needles” (numbness or tingling)

About This Resource  

Author: Waterloo Wellington Regional Cancer Program

Revised: March 2025

PEM#: PEMWHRNCC0037

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Use this resource for your information only. It does not replace medical advice from your doctor or other healthcare professionals.

Email: [email protected]

Website: www.cancerwaterloowellington.ca