Case Report: Active tuberculosis infection in CAR T-cell recipients post CAR T-cell therapy: a retrospective case series

High response rates in B-cell malignancies have been achieved with chimeric antigen receptor (CAR) T-cell therapy. Emerging reports indicate a risk of active tuberculosis (TB) with novel immunotherapy for tumors. However, studies of TB in patients post CAR T-cell therapy are limited. In this case se...

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Bibliographic Details
Published in:Frontiers in cellular and infection microbiology 2023-05, Vol.13, p.1147454
Main Authors: Zhang, Peiling, Huang, Liang, Zheng, Miao, Zhang, Chao, Wan, Dongyi, Wei, Jia, Cao, Yang
Format: Article
Language:English
Subjects:
Antigens, CD19
Cellular and Infection Microbiology
chimeric antigen receptor T-cell
extrapulmonary tuberculosis
Hematopoietic Stem Cell Transplantation
host immunity
Humans
immunocompromised
Immunotherapy, Adoptive - adverse effects
Retrospective Studies
T-Lymphocytes
Transplantation, Autologous
Tuberculosis
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Summary:High response rates in B-cell malignancies have been achieved with chimeric antigen receptor (CAR) T-cell therapy. Emerging reports indicate a risk of active tuberculosis (TB) with novel immunotherapy for tumors. However, studies of TB in patients post CAR T-cell therapy are limited. In this case series study, we describe five patients with active TB post CD19/CD22 target CAR T-cell therapy alone or following autologous stem cell transplantation (ASCT). One of the patients developed active TB within the first 30 days post CAR T-cell therapy, and fever was the dominant presenting symptom; extrapulmonary manifestations of active TB were common in the other four patients and manifested after the first 30 days of CAR T-cell therapy. Four of the five patients improved with anti-TB treatment, but one patient with isoniazid resistance died of central nervous system TB infection. Our study provides the first series report of active TB following CD19/CD22 target CAR T-cell therapy.
ISSN:2235-2988
2235-2988
DOI:10.3389/fcimb.2023.1147454