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Patients with aggressive B-cell lymphoma receiving CAR T-cell therapy have a low rate of severe infections despite lack of universal antibacterial and antifungal prophylaxis.
Pernas, B; Iacoboni, G; Los-Arcos, I; Carpio, C; Márquez-Algaba, E; Sanchez-Salinas, M A; Albasanz, A; Esperalba, J; Viñado, B; Camps, I Ruiz; Barba, P.
Afiliación
  • Pernas B; Infectious Diseases Unit, Department of Internal Medicine, University Hospital of A Coruña, A Coruña, Spain.
  • Iacoboni G; Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Los-Arcos I; Department of Hematology, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Carpio C; Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Márquez-Algaba E; Department of Hematology, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Sanchez-Salinas MA; Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Albasanz A; Department of Hematology, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Esperalba J; Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Viñado B; Department of Microbiology, University Hospital Vall d'Hebron, Barcelona, Spain.
  • Camps IR; CIBER of Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain.
  • Barba P; Department of Microbiology, University Hospital Vall d'Hebron, Barcelona, Spain.
Eur J Haematol ; 113(2): 227-234, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38665060
ABSTRACT

OBJECTIVES:

Our aim was to describe the frequency and severity of infectious complications after chimeric antigen receptor (CAR) T-cell therapy in patients with large B-cell lymphoma (LBCL).

METHODS:

We retrospectively reviewed clinical records of LBCL patients treated with CD19-targeted CAR T-cell therapy from July/2018 to December/2021 at our institution, and identified all infectious episodes from CAR T-cell infusion until disease progression, death or last follow-up.

RESULTS:

Overall, 137 patients were included. Thirty six percent had received ≥3 previous lines of therapy and 26% an autologous hematopoietic cell transplantation (auto-HCT). Cytokine release syndrome occurred in 87 (64%) patients. Antibacterial prophylaxis was not used in any patient; only 38% received antifungal prophylaxis. Sixty three infectious events were observed in 41 (30%) patients. Fifty two (83%) of the infectious events had at least one pathogen identified (bacteria [n = 38], virus [n = 11], and fungi [n = 3]). Most of the infectious events occurred during hospitalization for CAR-T treatment. Infection-related mortality was observed in two patients. Independent risk factors for infection included male gender, previous auto-HCT, ≥3 lines of treatment and pre-lymphodepletion neutropenia.

CONCLUSIONS:

Infections after CAR T-cell therapy in patients with lymphoma are frequent but generally not severe. A conservative and tailored antimicrobial prophylaxis seems to be a safe approach.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inmunoterapia Adoptiva / Antifúngicos Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Haematol Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inmunoterapia Adoptiva / Antifúngicos Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Haematol Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido