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Infection complications after lymphodepletion and dosing of chimeric antigen receptor T (CAR-T) cell therapy in patients with relapsed/refractory acute lymphoblastic leukemia or B cell non-Hodgkin lymphoma

Chimeric antigen receptor T (CAR-T) cell therapy has proven to be very effective in patients with relapsed/refractory acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL). However, infections—related either due to lymphodepletion or the CAR-T cell therapy itself—can result in severe and...

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Main Authors: Korell, Felix (Author) , Schubert, Maria-Luisa (Author) , Sauer, Tim (Author) , Schmitt, Anita (Author) , Derigs, Patrick (Author) , Weber, Tim (Author) , Schnitzler, Paul (Author) , Müller-Tidow, Carsten (Author) , Dreger, Peter (Author) , Schmitt, Michael (Author)
Format: Article (Journal)
Language:English
Published: 2 April 2021
In: Cancers
Year: 2021, Volume: 13, Issue: 7, Pages: 1-12
ISSN:2072-6694
DOI:10.3390/cancers13071684
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers13071684
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/13/7/1684
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Author Notes:Felix Korell, Maria-Luisa Schubert, Tim Sauer, Anita Schmitt, Patrick Derigs, Tim Frederik Weber, Paul Schnitzler, Carsten Müller-Tidow, Peter Dreger and Michael Schmitt
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Summary:Chimeric antigen receptor T (CAR-T) cell therapy has proven to be very effective in patients with relapsed/refractory acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL). However, infections—related either due to lymphodepletion or the CAR-T cell therapy itself—can result in severe and potentially life-threatening complications, while side effects such as cytokine release syndrome (CRS) might complicate differential diagnosis. Sixty-seven dosings of CAR-T cells in sixty adult patients with NHL (85%) and ALL (15%) receiving CAR-T cell therapy were assessed for infectious complications. Almost two-thirds of patients (61%) developed fever following lymphodepletion and CAR-T cell dosing. Microbiological or radiological findings were observed in 25% of all cases (bacterial 12%, viral 5%, fungal 8%). Inpatient infections were associated with more lines of therapy and more severe CRS. However, overall serious complications were rare after CAR-T therapy, with one patient dying of infection. Pathogen detection after inpatient stay was infrequent and mostly occurred in the first 90 days after dosing. Infections in CAR-T cell treated patents are common. Fast and suitable identification and treatment are crucial in these heavily pretreated and immunocompromised patients. In most cases infectious complications are manageable. Nonetheless, standardized anti-infective prophylaxis and supportive therapy are mandatory to reduce morbidity and mortality in CAR-T cell therapy.
Item Description:Gesehen am 18.02.2022
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers13071684

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