Characteristics and risk factors of infections following CD28-based CD19 CAR-T cells

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:...

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Bibliographic Details
Published in:Leukemia & lymphoma 2021-06, Vol.62 (7), p.1692-1701
Main Authors: Wittmann Dayagi, Talya, Sherman, Gilad, Bielorai, Bella, Adam, Etai, Besser, Michal J., Shimoni, Avichai, Nagler, Arnon, Toren, Amos, Jacoby, Elad, Avigdor, Abraham
Format: Article
Language:English
Subjects:
Adult
Antigens, CD19
CAR T-cells
CD28 Antigens
Child
cytokine-release syndrome
Humans
Immunotherapy, Adoptive
infections
leukemia
Leukemia - therapy
lymphoma
Lymphoma - therapy
Risk Factors
T-Lymphocytes
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Summary: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.
ISSN:1042-8194
1029-2403
DOI:10.1080/10428194.2021.1881506