Yescarta (axicabtagene ciloleucel) is a prescription biologic drug that’s used to treat certain types of non-Hodgkin’s lymphoma. Yescarta can cause side effects that range from mild to very serious. Examples include fever, fatigue, and confusion.

Specifically, Yescarta is used in adults to treat certain types of non-Hodgkin’s lymphoma (NHL):

  • large B-cell lymphoma (LBCL) that didn’t respond to, or came back after, initial cancer treatment
  • large B-cell lymphoma (LBCL) that didn’t respond to, or came back after, two or more previous treatments
  • follicular lymphoma (FL) that didn’t respond to, or came back after, two or more previous treatments

The active ingredient in Yescarta is axicabtagene ciloleucel. (An active ingredient is what makes a drug work.) The drug comes as a liquid suspension that’s made from your body’s own immune system T-cells. (T-cells are a type of white blood cell.) Yescarta is given as a one-time infusion into a vein.

Keep reading to learn about the common, mild, and serious side effects that Yescarta can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild to serious side effects during their Yescarta treatment. Examples of the drug’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects have been reported with Yescarta. These include:

  • nausea and vomiting
  • diarrhea or constipation
  • belly pain
  • swelling in the hands, legs, and feet
  • lack of appetite
  • tremor
  • slurred speech
  • mild infections
  • cough
  • muscle and joint pain
  • headache
  • fatigue (low energy)
  • mild allergic reaction*

In most cases, these side effects are temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist.

Yescarta may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.

Serious side effects that have been reported with Yescarta include:

  • a long period of low white blood cell counts with fever
  • a long period of low red blood cells
  • low oxygen levels in body tissues
  • low levels of antibodies in the blood
  • low blood pressure
  • pulmonary embolism or blood clot in the leg
  • heartbeat that’s too fast or irregular
  • heart failure
  • dizziness
  • confusion
  • fever and chills
  • heart attack
  • decreased platelet count
  • low kidney function
  • decreased blood phosphate, sodium, and potassium levels
  • serious infections, such as pneumonia or sepsis (infection in the blood)
  • other cancers
  • boxed warning: risk of CRS, nervous system problems including encephalopathy (decline in brain function), and other immune system cancers*
  • severe allergic reaction*

If you develop serious side effects after discharge from the treatment facility, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Yescarta, visit MedWatch.

To report SUSPECTED ADVERSE REACTIONS, contact Kite at 1-844- 454-KITE (5483) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Get answers to some frequently asked questions about Yescarta’s side effects.

How do side effects of Yescarta compare with those seen with Kymriah?

Yescarta and Kymriah are the same type of cancer treatment. They’re called chimeric antigen receptor therapy. With this type of treatment, your T-cells (a kind of white blood cell) are modified to locate and destroy cancer cells.

The active ingredient in Yescarta is axicabtagene ciloleucel. The active ingredient in Kymriah is tisagenlecleucel.

Both Yescarta and Kymriah may cause similar side effects, such as:

  • CRS
  • nervous system problems
  • other cancers
  • serious infections
  • low blood antibody levels
  • low blood cell counts
  • severe allergic reactions

However, it is unclear whether one treatment has fewer side effects than the other. This is because these treatments have been available for less than a decade, and comparative studies are lacking.

To learn more about how these medications compare, talk with your doctor.

Does Yescarta cause long-term side effects?

It’s possible. Long-term side effects include those that may start at any time during treatment with a drug. They also include side effects that may not go away.

Examples of long-term side effects reported in Yescarta’s studies include:

  • encephalopathy (impaired brain function)
  • peripheral neuropathy
  • low blood antibody levels
  • other cancers
  • increased risk of infections, including progressive multifocal leukoencephalopathy (a brain infection)
  • heart, lung, kidney, or liver problems

If you’re concerned about possible long-term side effects from Yescarta, talk with your doctor.

Learn more about some of the side effects Yescarta may cause.

Cytokine release syndrome (CRS)

CRS was a common side effect reported in studies of Yescarta. It is a serious condition that can cause problems such as organ damage. In rare cases, CRS caused fatal or life threatening reactions.

CRS may cause symptoms such as:

  • fatigue (low energy)
  • fever or chills
  • fast or irregular heartbeat
  • headache
  • low blood pressure
  • low blood oxygen levels or shortness of breath

CRS can begin about 2–3 days after a Yescarta infusion and last about 7 days. But CRS can occur up to 1 month after Yescarta infusion. So it is important to look for side effects for 1 month after your infusion and report them to your treatment team right away.

Factors that can increase the risk of CRS during Yescarta treatment include:

What might help

To prevent CRS after Yescarta treatment, your doctor will likely prescribe diphenhydramine (Benadryl), which is an allergy medication. They will also likely prescribe acetaminophen (Tylenol), a pain and fever reliever. You’ll probably take these medications 1 hour before your Yescarta infusion. Your doctor may also consider having you take a corticosteroid to reduce your risk of CRS.

After your infusion, if you begin to have a CRS reaction, your doctor will treat you right away. They may give you:

  • tocilizumab (a type of monoclonal antibody) and
  • a corticosteroid.

Treatment with these medications decreases the risk of brain and organ injury from a CRS reaction.

Nervous system problems

Nervous system problems were a common side effect reported in studies of Yescarta. They typically occur along with CRS or after CRS resolves. In rare cases, nervous system problems resulted in life threatening or fatal reactions.

Nervous system problems can be serious and may cause:

  • encephalopathy (a decline in brain function that can result in symptoms such as confusion, memory loss, agitation, and personality change)
  • progressive multifocal leukoencephalopathy, or PML (a type of brain infection)
  • tremor
  • slurred speech or inability to speak
  • weakness
  • insomnia
  • headache
  • dizziness
  • seizures
  • brain swelling

Certain factors can increase the risk of nervous system problems during Yescarta treatment. They include a history of problems such as seizures, memory loss, or stroke. Because of the possibility of these nervous system reactions, your doctor will likely tell you to avoid driving for at least 8 weeks after your infusion.

What might help

If you have symptoms of nervous system problems, call your doctor immediately. They will likely treat you with:

The faster these medications are started, the lower the risk of brain swelling and injury.

Immune system cancers

Immune system cancers have been reported as soon as a few weeks after receiving treatment with Yescarta. Some of these cancers have been fatal such as T-cell malignancies.

You may not have any signs of the disease in the early stages. Symptoms vary according to the specific type of cancer.

What might help

Talk with your doctor about possible symptoms of immune system cancers. And report any new symptoms that you have and keep regularly scheduled follow-up appointments for lab work and with your doctor.

Allergic reaction

Like most drugs, Yescarta can cause an allergic reaction in some people.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction during infusion, such as a mild rash, alert your doctor right away. They will likely stop the Yescarta infusion and suggest a treatment to manage your symptoms. Examples of possible treatments include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Yescarta, they’ll decide whether you should continue the infusion.

If you have symptoms of a severe allergic reaction after your infusion but before you leave the treatment center, your doctor may treat you with the same medications listed above.

But if you have symptoms of a severe allergic reaction after discharge, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

Keeping track of side effects

After your Yescarta treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you are first released from the treatment center.

Your side effect notes can include things such as:

  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Yescarta affects you. They can then use this information to adjust your treatment plan if needed. If you have symptoms of CRS or nervous system problems, notify your treatment team and seek emergency medical treatment immediately.

Below is important information you should consider before starting your Yescarta treatment.

Boxed warnings

Yescarta has boxed warnings about the risk of CRS nervous system problems, and T-cell malignancies (immune system cancers). Boxed warnings are the most serious warnings from the FDA.

Risk of cytokine release syndrome (CRS) warning: Researchers have linked Yescarta to CRS reactions, which in some cases can be life threatening or fatal. People with an active infection or inflammatory disorders should not be given Yescarta. Tocilizumab, or a combination of tocilizumab and corticosteroids, can be used to treat severe or life threatening CRS.

Risk of nervous system problems warning: Researchers have linked Yescarta with nervous system problems in certain people who also have CRS or have recently resolved CRS. In some cases, these problems can be life threatening or fatal. Supportive care and corticosteroids may be needed to treat severe nervous system problems.

Risk of immune system cancers: Researchers have linked Yescarta with immune system cancers. In some cases, these cancers can be life threatening or fatal.

REMS program: Yescarta can only be given as part of the Yescarta and Tecartus REMS (Risk Evaluation and Mitigation Strategy) program. As part of this program, Yescarta can only be administered at an authorized treatment facility by trained healthcare professionals. This is because of the risk of serious side effects from Yescarta (CRS and nervous system problems). For more information about this program, see this page.

To learn more about CRS and nervous system problems, see the “Side effects explained” section above.

Other warnings

Yescarta can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Yescarta is a suitable treatment option for you.

Talk with your doctor about your health history before you take Yescarta. Be sure to tell them if any of the following factors apply to you:

  • active infection
  • kidney disease
  • liver disease
  • brain disorders such as stroke or seizures
  • lung disease
  • heart disease
  • history of hepatitis B infection
  • immune system disorders that require immune-suppressing medication
  • allergy to dimethyl sulfoxide or gentamicin
  • use of prescription medications, over-the-counter drugs, herbs, vitamins, or nutritional supplements
  • past allergic reaction to Yescarta
  • pregnancy
  • breastfeeding

Alcohol and Yescarta

There are no known interactions between alcohol and Yescarta. However, drinking alcohol after your Yescarta infusion may worsen the treatment’s side effects. These can include headache, nausea, vomiting, and fatigue (low energy).

If you have questions about consuming alcohol during Yescarta treatment, talk with your doctor.

Pregnancy and breastfeeding with Yescarta

Before starting Yescarta treatment, it’s important to talk with your doctor if you’re pregnant, breastfeeding, or planning to become pregnant or breastfeed.

Pregnancy

Yescarta is not recommended for use in people who are pregnant. This is because Yescarta has not been studied in pregnant people, and it is unclear whether the drug is safe for this use. If you’re pregnant or planning to become pregnant, talk with your doctor before starting treatment with Yescarta.

Before starting this medication, your doctor will order a pregnancy test to confirm that you are not pregnant.

If you or your partner are able to become pregnant, your doctor will recommend using a form of birth control. They’ll likely recommend that you use it for a certain amount of time before and after your pretreatment chemotherapy before your Yescarta infusion.

If you become pregnant after your Yescarta infusion, notify your doctor right away. And if you have questions about Yescarta and pregnancy, talk with your doctor.

Breastfeeding

It isn’t known whether Yescarta is safe to take while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before starting this medication.

Like most drugs, Yescarta can cause a number of side effects that range from mild to serious. If you have questions about side effects that Yescarta can cause, talk with your doctor.

Examples of questions to help get you started include:

  • How likely am I to have severe side effects from Yescarta?
  • How can I manage the side effects of Yescarta?
  • What is the likelihood of permanent CRS or nervous system problems resulting from Yescarta?
  • Which Yescarta side effects do I need to call you about right away?

To learn more about Yescarta, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.