Infection epidemiology in relation to different therapy phases in patients with haematological malignancies receiving CAR T-cell therapy.
CAR T-cell
epidemiology
haematological malignancies
infections
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
25 Oct 2023
25 Oct 2023
Historique:
revised:
05
10
2023
received:
22
07
2023
accepted:
09
10
2023
medline:
26
10
2023
pubmed:
26
10
2023
entrez:
25
10
2023
Statut:
aheadofprint
Résumé
We described the real-life epidemiology and causes of infections on the different therapy phases in patients undergoing chimeric antigen receptor (CAR) T-cells directed towards CD19+ or BCMA+ cells. All consecutive patients receiving CAR T-cell therapy at our institution were prospectively followed-up. We performed various comparative analyses of all patients and subgroups with and without infections. Ninety-one adults mainly received CAR T-cell therapy for acute leukaemia (53%) and lymphoma (33%). We documented a total of 77 infections in 47 (52%) patients, 37 (48%) during the initial neutropenic phase and 40 (52%) during the non-neutropenic phase. Infections during the neutropenic phase were mainly due to bacterial (29, 78%): catheter infections (11 [38%] cases), endogenous source (5 [17%]), and Clostridioides difficile (5 [17%]). Patients receiving corticosteroids after CAR T-cell therapy had a higher risk of endogenous infection (100% vs. 16%; p = .006). During the non-neutropenic phase, bacterial infections remained very frequent (24, 60%), mainly with catheter source (8, 33%). Respiratory tract infections were common (17, 43%). Infections after CAR T-cell therapy were frequent. During the neutropenic phase, it is essential to prevent nosocomial infections and balance the use of antibiotics to lower endogenous bacteraemia and Clostridial infection rates.
Sections du résumé
BACKGROUND
BACKGROUND
We described the real-life epidemiology and causes of infections on the different therapy phases in patients undergoing chimeric antigen receptor (CAR) T-cells directed towards CD19+ or BCMA+ cells.
METHODS
METHODS
All consecutive patients receiving CAR T-cell therapy at our institution were prospectively followed-up. We performed various comparative analyses of all patients and subgroups with and without infections.
RESULTS
RESULTS
Ninety-one adults mainly received CAR T-cell therapy for acute leukaemia (53%) and lymphoma (33%). We documented a total of 77 infections in 47 (52%) patients, 37 (48%) during the initial neutropenic phase and 40 (52%) during the non-neutropenic phase. Infections during the neutropenic phase were mainly due to bacterial (29, 78%): catheter infections (11 [38%] cases), endogenous source (5 [17%]), and Clostridioides difficile (5 [17%]). Patients receiving corticosteroids after CAR T-cell therapy had a higher risk of endogenous infection (100% vs. 16%; p = .006). During the non-neutropenic phase, bacterial infections remained very frequent (24, 60%), mainly with catheter source (8, 33%). Respiratory tract infections were common (17, 43%).
CONCLUSIONS
CONCLUSIONS
Infections after CAR T-cell therapy were frequent. During the neutropenic phase, it is essential to prevent nosocomial infections and balance the use of antibiotics to lower endogenous bacteraemia and Clostridial infection rates.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : European Regional Development Fund
ID : FIS PI21/01640
Organisme : European Regional Development Fund
ID : ICI21/00103
Organisme : European Regional Development Fund
ID : JR20/00012
Organisme : European Regional Development Fund
ID : PI21/00498
Organisme : European Regional Development Fund
ID : PICI14/122
Organisme : European Regional Development Fund
ID : PI13/676
Organisme : European Regional Development Fund
ID : PIE13/33
Organisme : European Regional Development Fund
ID : PI18/775
Organisme : European Regional Development Fund
ID : ICI 19/00025
Organisme : Instituto de Salud Carlos III
Organisme : Ministerio de Sanidad, Consumo y Bienestar
Informations de copyright
© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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