CAR-T cell therapy and infection: a review

Bupha‐Intr, Olivia; Haeusler, Gabrielle M; Chee, Lynette; Thursky, Karin; Slavin, Monica A; Teh, Benjamin W

doi:10.1080/14787210.2021.1855143

Cited by 66 publications

(97 citation statements)

References 43 publications

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“…Several mechanisms underlie the increased susceptibility for infection in patients undergoing CAR T-cell therapy. Hematologic malignancies inherently result in dysfunction of the immune system, and subsequent chemotherapies contribute to cumulative immune dysfunction [46]. In a retrospective cohort study by Hill et al [47], patients with ³4 previous lines of therapy prior to CAR T-cell therapy demonstrated a significantly higher rate of infection compared to patients with <4 prior treatments, with an adjusted ratio of infection density of 3.53 (p<.001).…”

Section: Infectionmentioning

confidence: 99%

“…Furthermore, lymphodepleting chemotherapy prior to receiving CAR T-cell therapy can result in cytopenia as well as disruption of mucosal barriers, compromising both the adaptive and innate immune systems [46].…”

Section: Infectionmentioning

confidence: 99%

“…A N U S C R I P T [46,50]. Bacterial infections such as bacteremia and pneumonia from nosocomial Gram-negative and Gram-positive bacteria, C. difficile, and endogenous flora are reported in 16.5% of patients during the first 30 days following treatment [51].…”

Section: A C C E P T E D Mmentioning

confidence: 99%

“…Bacterial infections such as bacteremia and pneumonia from nosocomial Gram-negative and Gram-positive bacteria, C. difficile, and endogenous flora are reported in 16.5% of patients during the first 30 days following treatment [51]. Non-respiratory viral infections such as Epstein-Barr virus, herpes simplex virus (HSV) or varicella zoster virus (VZV) are more likely to present during the early phase, but respiratory viral infections are more common >30 days following treatment (8% of patients) [46,47]. Invasive fungal infections are life-threatening complications that occur in 8% and 3% of patients during the early and late periods, respectively [46].…”

Section: A C C E P T E D Mmentioning

confidence: 99%

“…Non-respiratory viral infections such as Epstein-Barr virus, herpes simplex virus (HSV) or varicella zoster virus (VZV) are more likely to present during the early phase, but respiratory viral infections are more common >30 days following treatment (8% of patients) [46,47]. Invasive fungal infections are life-threatening complications that occur in 8% and 3% of patients during the early and late periods, respectively [46].…”

Section: A C C E P T E D Mmentioning

confidence: 99%

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CAR T-Cell Therapy: An Update for Radiologists

Yoon

Smith

Tirumani

et al. 2021

American Journal of Roentgenology

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The publication of this Accepted Manuscript is provided to give early visibility to the contents of the article, which will undergo additional copyediting, typesetting, and review before it is published in its final form. During the production process, errors may be discovered that could affect the content of the Accepted Manuscript. All legal disclaimers that apply to the journal pertain. The reader is cautioned to consult the definitive version of record before relying on the contents of this document.

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Section: Infectionmentioning

confidence: 99%

Section: Infectionmentioning

confidence: 99%

Section: A C C E P T E D Mmentioning

confidence: 99%

Section: A C C E P T E D Mmentioning

confidence: 99%

Section: A C C E P T E D Mmentioning

confidence: 99%

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CAR T-Cell Therapy: An Update for Radiologists

Yoon

Smith

Tirumani

et al. 2021

American Journal of Roentgenology

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Improving the safety of CAR‐T‐cell therapy: The risk and prevention of viral infection for patients with relapsed or refractory B‐cell lymphoma undergoing CAR‐T‐cell therapy

Qian,

Yang,

Zhang

et al. 2024

American J Hematol

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Chimeric antigen receptor (CAR) T‐cell therapy, an innovative immunotherapeutic against relapsed/refractory B‐cell lymphoma, faces challenges due to frequent viral infections. Despite this, a comprehensive review addressing risk assessment, surveillance, and treatment management is notably absent. This review elucidates immune response compromises during viral infections in CAR‐T recipients, collates susceptibility risk factors, and deliberates on preventive strategies. In the post‐pandemic era, marked by the Omicron variant, new and severe threats to CAR‐T therapy emerge, necessitating exploration of preventive and treatment measures for COVID‐19. Overall, the review provides recommendations for viral infection prophylaxis and management, enhancing CAR‐T product safety and recipient survival.

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Infections associated with CAR‐T cell therapy in patients with relapsed refractory multiple myeloma: Risks and prevention strategies

An,

Zhao,

Zou

et al. 2024

Cancer Medicine

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BackgroundChimeric antigen receptor T (CAR‐T) cell therapy has emerged as a potent treatment for relapsed or refractory multiple myeloma, demonstrating significant clinical efficacy. Despite these advances, treatment‐related toxicities, particularly infections, pose a significant challenge to patient safety.MethodsThis review synthesizes current knowledge on the mechanisms underlying post‐CAR‐T therapy infections, focusing on the interplay between immune dysfunction, host factors, and treatment‐induced toxicity. It provides a comprehensive analysis of the temporal and individual variability in infection characteristics and the confounding clinical presentation of cytokine release syndrome.ResultsThe review identifies that patients receiving CAR‐T cells are at increased risk of concurrent infections due to the heterogeneity in infection characteristics across different time periods, individuals, and patient groups. It highlights the diagnostic and therapeutic complexities introduced by the overlapping symptoms of infection and cytokine release syndrome.ConclusionTo enhance the infection control post‐CAR‐T therapy, this review proposes preventive strategies tailored to the early and long‐term management of patients. It underscores the need for a nuanced understanding of infection mechanisms and the importance of personalized prevention plans to improve clinical outcomes in multiple myeloma treatment.

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CAR-T cell therapy and infection: a review

Cited by 66 publications

References 43 publications

CAR T-Cell Therapy: An Update for Radiologists

CAR T-Cell Therapy: An Update for Radiologists

Improving the safety of CAR‐T‐cell therapy: The risk and prevention of viral infection for patients with relapsed or refractory B‐cell lymphoma undergoing CAR‐T‐cell therapy

Infections associated with CAR‐T cell therapy in patients with relapsed refractory multiple myeloma: Risks and prevention strategies

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