Key takeaways

  • Kymriah is a prescription medication used to treat certain types of leukemia and lymphoma. It can cause side effects ranging from mild to serious.
  • Mild side effects include infection, headache, and fatigue. Possible serious side effects include cytokine release syndrome (CRS), nervous system problems, and the potential development of white blood cell cancers.
  • Due to the potential for severe side effects, you’ll receive daily monitoring for a week after your Kymriah infusion. After you leave, you’ll need to stay near the facility for at least 2 weeks in case of serious side effects.

Specifically, Kymriah has Food and Drug Administration (FDA) approval to treat certain refractory or relapsed leukemias or lymphomas. (“Refractory” means the cancer is not responding to treatment. “Relapsed” means the cancer responded to treatment but came back.) These include:

The FL indication has FDA accelerated approval, which means Kymriah shows promise in treating FL. However, the FDA requires more studies to confirm the benefits in this particular use.

Keep reading to learn about the common, mild, and serious side effects that Kymriah can cause. For a general overview of the drug, including more details about its uses and how it works, read this Kymriah overview.

Kymriah has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see the “Side effects explained” section.

Some people may experience mild to serious side effects during their Kymriah treatment. The following lists contain a few of the more common side effects reported by people who took Kymriah in studies. These side effects can vary depending on what condition the drug is being used to treat.

When receiving Kymriah for ALL

More common side effects in people receiving Kymriah for ALL include:

When receiving Kymriah for FL

More common side effects in people receiving Kymriah for FL include:

  • infection
  • fatigue (low energy)
  • headache
  • muscle and joint pain
  • CRS

When receiving Kymriah for DLBCL

More common side effects in people receiving Kymriah for DLBCL include:

To learn more about CRS, see the “Side effects explained” section.

The following sections include more side effects of Kymriah. Each person’s experience with side effects may differ.

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

  • fatigue
  • shortness of breath
  • swelling of hands, legs, and feet
  • muscle and joint pain
  • cough
  • diarrhea
  • nausea or vomiting
  • headache
  • low appetite
  • fever

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

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

Serious side effects have been reported in studies of Kymriah. These include:

Because of Kymriah’s potential for causing life threatening side effects, you’ll receive your infusion in a medical facility that’s prepared to manage them. You’ll need to stay near the facility for 2 weeks following your infusion so your doctor can monitor you for any side effects and ensure that Kymriah is effective.

If you develop serious side effects after you leave the Kymriah infusion 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. Be sure to inform the emergency medical personnel that you received a Kymriah infusion. This allows them to ensure that you receive the proper care.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect during Kymriah treatment and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

For some people, Kymriah can cause an allergic reaction.

In general, symptoms of an allergic reaction can be mild or serious.

Novartis, the manufacturer of Kymriah, states that serious allergic reactions may be related to the inactive ingredients in Kymriah. The ingredients are dimethyl sulfoxide (DMSO) and dextran 40. These inactive ingredients may cause allergic reactions during Kymriah infusion.

What might help

Your doctor may prescribe diphenhydramine and acetaminophen before your infusion to help reduce the risk of an allergic reaction.

After discharge from a Kymriah infusion facility, watch for symptoms of allergic reaction. If you have mild symptoms, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms.

If you have severe symptoms, such as swelling or difficulty breathing, call 911 or a local emergency number right away. These symptoms could be life threatening and require immediate medical care.

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

Can using Kymriah and sargramostim together increase side effects?

Yes, this combination could increase side effects. Sargramostim is a cytokine called granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSFs boost the production and function of white blood cells such as granulocytes and macrophages.

Some people develop low white blood cells during or after cancer treatment. In this case, their doctor will use GM-CSFs to increase their white blood cells and help prevent infection. But because of how GM-CSFs work, the risk of CRS side effects may be higher when using them. It is recommended not to use GM-CSF during the first 3 weeks after Kymriah infusion or until CRS has resolved.

If you’d like more information, you can read the drug’s prescribing information or talk with your doctor.

Will Kymriah cause side effects that will prevent me from driving?

Yes, Kymriah can cause problems that interfere with driving. These include:

  • dizziness or drowsiness
  • tremor
  • confusion
  • coordination problems
  • memory loss
  • seizure

These side effects can impair judgment and reflexes. Because of this, do not drive or use machinery for at least 2 weeks after your Kymriah infusion.

The following side effects were reported more commonly in the ALL study, which involved people ages 2 to 25 years. This is a comparison to the DLBCL and FL studies in adults. So it’s not clear whether these side effects occurred more commonly due to the type of cancer or the study participants’ ages. The side effects are:

  • fever
  • low white blood cell count with fever
  • vomiting
  • low antibody level
  • low appetite
  • muscle and joint pain
  • bleeding
  • headache
  • serious infection
  • severe immune system overreaction

For more information about potential side effects of Kymriah in children, talk with your doctor or pharmacist.

Kymriah has boxed warnings for CRS, nervous system problems, and white blood cell cancers. A boxed warning is the most serious warning from the FDA. A boxed warning alerts doctors and patients about side effects that may be dangerous.

CRS

CRS was a common side effect reported in studies of Kymriah. For most people, this is a mild reaction. But for others, it can be life threatening.

CRS may cause symptoms such as:

Factors that can increase the risk of severe CRS when receiving this drug include:

  • a high number of tumor cells in the bone marrow
  • a fast-growing tumor relapse after chemotherapy
  • an active infection
  • inflammation disorders, such as rheumatoid arthritis

What might help

Your doctor will have tocilizumab and corticosteroids available during your infusion. These treat severe or life threatening CRS.

After discharge from a Kymriah infusion facility, watch for symptoms of CRS. If you develop any, call 911 or a local emergency number right away. These symptoms could be life threatening and require immediate medical care.

Nervous system problems

Nervous system problems were a common side effect reported in studies of Kymriah. Nervous system problems may cause symptoms such as:

  • headache
  • dizziness
  • tremor
  • memory loss
  • confusion
  • anxiety
  • sleep problems
  • personality changes
  • seizure
  • loss of speech
  • coma (in extreme cases or if untreated)

Some factors that can increase the risk of nervous system problems when receiving this drug include:

What might help

If you develop nervous system problems during Kymriah infusion, your doctor may start corticosteroids to reduce their severity.

After discharge from a Kymriah infusion facility, watch for nervous system problems that seem severe. If you develop any, call 911 or a local emergency number right away. These problems could be life threatening and require immediate medical care.

White blood cell cancers

Formation of was a rare side effect reported to the FDA after Kymriah was approved for use. Some cases occurred as soon as a few weeks after Kymriah treatment. In these cases, the new cancer types appeared, or the cancer being treated recurred. This side effect has led to fatal results.

White blood cell cancer may cause symptoms such as:

Factors that can increase the risk of developing white blood cell cancer include:

  • family history of white blood cell cancer
  • smoking
  • past use of chemotherapy or radiation therapy

What might help

If you have symptoms of white blood cell cancer after Kymriah treatment, call your doctor right away. They’ll likely recommend an urgent medical evaluation, blood work, and body scans.

Consider the following important information before receiving Kymriah.

Boxed warnings

Kymriah has boxed warnings for risks of CRS, nervous system problems, and white blood cell cancers. A boxed warning is the most serious warning from the FDA. For details, see the “Side effects explained” section.

Other warnings

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

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

  • weak immune system
  • inflammation disorders, such as rheumatoid arthritis
  • history of HIV, hepatitis B, or hepatitis C
  • active infection
  • allergy to DMSO or dextran 40
  • past allergic reaction to Kymriah
  • use of other prescription medications, over-the-counter drugs, vitamins, nutritional supplements, or herbs
  • pregnancy
  • breastfeeding
  • alcohol consumption

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.