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T-cell-based immunotherapy has recently evolved as a treatment option for a number of haematological malignancies and is also being developed in solid tumours. A common side effect of chimeric antigen T-cell therapy (CAR-T) and treatment with T-cell engagers is cytokine release syndrome (CRS), which is a potentially life-threatening condition characterized by release of inflammatory mediators. The treatment of CRS is similar to that of other hyper-inflammatory conditions and involves supportive treatment as well as immunosuppressive therapy. The risk of CRS can be mitigated by step-up dosing and immunosuppressive pre-treatment, as argued in this review., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Malignant hematologic diseases resistant to chemotherapy can be cured by immune cellular therapy. Bone marrow transplantation (BMT) elicits a "pan-immunologic" attack, whereas therapy with chimeric antigen receptor (CAR)-T is a targeted attack. The immunologic activity after BMT can be adjusted by selection of donor cells before transplantation, or with post-BMT sequential chemotherapy. Many haematologic diseases are clonal, and the development of CAR-T cellular therapy directed against a variety of epitopes is under development as summarised in this review.

Although treatment of haematological cancer has improved significantly during the latest decades, the prognosis is poor in case of relapse or refractory disease. This review describes the chimeric antigen receptor (CAR) T-cell therapy, which has emerged as a new promising treatment principle, in which the patient's own T-cells are genetically modified to recognise cancer cells. The possible side effects are usually only transient. A commercial CD19 CAR T-cell product has recently been approved as treatment for acute lympho-blastic leukaemia in children and young adults in Denmark, and a non-commercial CAR T-cell production is being established.

Immunosuppression with chemotherapy followed by autologous haematopoietic stem cell transplantation has proven to be an effective long-term treatment for younger patients with relapsing-remitting multiple sclerosis and clinical as well as radiological evidence of high disease activity. The conditioning regimen can be of either high, intermediate or low intensity. Due to the safety profile and favourable efficacy measures, the low intensity regimen cyclophosphamide + anti-thymocyte globulin is currently used in Denmark as standard regimen.