Full Library
Infectious complications of car T‐cell therapy: A longitudinal risk model
Resource type
Journal Article
Authors/contributors
- Czapka, Michael T. (Author)
- Riedell, Peter A. (Author)
- Pisano, Jennifer C. (Author)
Title
Infectious complications of car T‐cell therapy: A longitudinal risk model
Abstract
Abstract
Background
CAR T‐cell therapy, where a patient's own T cells are re‐engineered to express a receptor to a target of interest, is becoming an increasingly utilized cancer‐directed therapy. There are significant toxicities that contribute to a novel state of immunocompromise, leading to new patterns of infectious complications that require further detailed study.
Methods
We created a single‐center cohort of adult recipients of CD19‐directed CAR T‐cell therapy and assessed infectious outcomes, supportive care received, toxicities, and markers of immune function up to 2 years following CAR T‐cell therapy. Descriptive statistics were used as appropriate for analysis. We additionally conducted time‐to‐event analysis assessing time‐to‐first infection with either log‐rank testing or Cox regression with univariate analysis, before including significant predictors into a multivariate Cox model of time to infection.
Results
We identified 73 patients who received CD19‐directed CAR T‐cell therapy who predominantly had diffuse large B‐cell lymphoma. Within 30 days of cell infusion, bacterial and
Candida
infections were the most common, with 64% of infections due to these organisms. Between 30 days and 2 years postinfusion, respiratory viruses and pneumonia were the most frequent infections, with 68% of infections due to these etiologies. Receipt of tocilizumab, development of immune effector cell‐associated neurotoxicity syndrome (ICANS), or lower neutrophil count were associated with quicker onset of infection in a multivariate Cox model.
image
Conclusions
Respiratory viruses remain an important infectious complication of CAR T‐cell therapy following the first year. The model may be a useful tool to identify patients at the highest risk of infection.
Publication
Transplant Infectious Disease
Date
2023-09-11
Pages
e14148
Journal Abbr
Transplant Infectious Dis
Accessed
10/4/23, 9:10 AM
ISSN
1398-2273, 1399-3062
Short Title
Infectious complications of car T‐cell therapy
Language
en
Library Catalog
DOI.org (Crossref)
Citation
Czapka, M. T., Riedell, P. A., & Pisano, J. C. (2023). Infectious complications of car T‐cell therapy: A longitudinal risk model. Transplant Infectious Disease, e14148. https://doi.org/10.1111/tid.14148
HEME-ONC AND CELLULAR THERAPIES
Link to this record