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

Talya Wittmann Dayagi, Gilad Sherman, Bella Bielorai, Etai Adam, Michal J. Besser, Avichai Shimoni, Arnon Nagler, Amos Toren, Elad Jacoby, Abraham Avigdor

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1692-1701
Number of pages10
JournalLeukemia and Lymphoma
Volume62
Issue number7
DOIs
StatePublished - 2021

Keywords

  • CAR T-cells
  • cytokine-release syndrome
  • infections
  • leukemia
  • lymphoma

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