Characteristics and risk factors of infections following CD28-based CD19 CAR-T cells. Issue 7 (7th June 2021)

• Record Type: Journal Article
• Authors: Wittmann Dayagi, Talya; Sherman, Gilad; Bielorai, Bella; Adam, Etai; Besser, Michal J.; Shimoni, Avichai; Nagler, Arnon; Toren, Amos; Jacoby, Elad; Avigdor, Abraham
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 7(2021)
• Page Start: 1692
• Page End: 1701
• Publication Date: 2021-06-07
• Subjects: CAR T-cells -- leukemia -- lymphoma -- infections -- cytokine-release syndrome; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1881506
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: CAR T-cells are approved for the treatment of relapsed and refractory leukemia and lymphoma. Here, we studied the infectious complications in 88 patients treated with CD28-based CD19 CAR T-cells. Overall, 36 infections were documented in 24 patients within the first month after CAR T-cell infusion: Six events of bacteremia, sixteen focal bacterial infections, and fourteen systemic or localized viral infections. Seven patients had nine infectious episodes beyond the first 30 days of follow-up, including three events of bacteremia, three focal bacterial, two viral and one fungal infection. The presence of neutropenia, neutropenic fever and lack of response to treatment were associated with a higher rate of infections. Children had less severe infections than adults. In a multivariate analysis lack of response to treatment was the only significant risk factor. Overall, the incidence of bacterial infections following CAR T-cells is modest especially in children and in patients responding to therapy.