Key takeaways

  • Yescarta (axicabtagene ciloleucel) is a prescription biologic drug that treats 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.
  • After receiving Yescarta, you’ll be monitored closely for serious side effects, which may include cytokine release syndrome, nervous system problems, and low blood cell counts.

Specifically, Yescarta is used in adults to treat the following types of non-Hodgkin’s lymphoma:

  • large B-cell lymphoma that didn’t respond to, or came back after:
    • initial cancer treatment or
    • two or more previous treatments
  • follicular lymphoma 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. To learn more about Yescarta, including details about its uses, read this Yescarta overview.

Yescarta has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Boxed warnings for Yescarta” section.

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

For more information about some of these side effects, see the “Tips for managing side effects” and “Boxed warnings for Yescarta” sections.

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

  • nausea and vomiting
  • diarrhea or constipation
  • belly pain
  • swelling of the body, including 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.

Yescarta may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to Yescarta’s prescribing information.

If you develop serious side effects after you leave the treatment center, 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.

Serious side effects that have been reported with Yescarta include:

For more information about some of these side effects, see the “Tips for managing side effects” and “Boxed warnings for Yescarta” sections.

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 Yescarta treatment and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Yescarta has boxed warnings. A boxed warning is the most serious warning from the FDA. They alert doctors and patients about drug effects that may be dangerous.

Note: You will likely stay at the treatment center to be monitored for at least 7 days after your infusion. Once they release you, you’ll need to stay near the treatment center (within 2 hours) and monitor for CRS for at least 2 weeks. If you have any symptoms of CRS, you should contact your doctor, and they will likely ask you to return to the treatment center for care.

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

CRS can begin about 2 to 3 days after a Yescarta infusion and last about 7 days. But CRS can occur up to 1 month after Yescarta infusion. So it’s 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’ll also 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 it 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
  • 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

Due to the risk of immune system cancers, you’ll have regular follow-up appointments so your doctor can monitor for this side effect. Talk with your doctor about possible symptoms of immune system cancers, and report any new symptoms that you have. Keeping all regularly scheduled follow-up appointments for lab work and with your doctor is essential.

There may be things you can do to help make certain Yescarta side effects more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other available treatment options for your condition.

Low blood pressure

Hypotension (low blood pressure) was a common side effect in studies of Yescarta. It was usually mild, but some people experienced severely low blood pressure.

Symptoms of this side effect include:

  • feeling dizzy
  • feeling tired
  • shortness of breath
  • headache

What might help

Your care team will monitor this side effect while you’re at the healthcare center. They may decide to treat it with medications that increase your blood pressure. If you have symptoms of this side effect after you leave the center, call your doctor or a member of your healthcare team. They’ll advise you on the next steps.

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.

Here are answers to some commonly 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’s 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 there are no head-to-head studies comparing the two treatments.

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.

Consider the following important information before starting your Yescarta treatment.

Yescarta has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see “Boxed warnings for Yescarta.”

Other precautions

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, liver, heart, or lung disease
  • brain disorders such as stroke or seizures
  • history of hepatitis B infection
  • immune system disorders that require immune-suppressing medication
  • allergy to dimethyl sulfoxide or gentamicin
  • past allergic reaction to Yescarta
  • pregnancy
  • breastfeeding
  • alcohol consumption

Also, tell your doctor about any prescription medications, over-the-counter drugs, herbs, vitamins, or nutritional supplements you take. They’ll determine whether any of these substances may interact with Yescarta.

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?

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.