Khan Abdul Moiz, Ajmal Zainub, Tuz Zahra Fatima, Ramani Ananthakrishnan, Zackon Ira
Department of Internal Medicine, Albany Medical Center, Albany, NY, USA.
Department of Infectious Diseases, Albany Medical Center, Albany, NY, USA.
Case Rep Hematol. 2020 Nov 27;2020:6621967. doi: 10.1155/2020/6621967. eCollection 2020.
Patients who undergo chimeric antigen receptor T-cell therapy (CAR T-cell therapy) are immunosuppressed due to multiple factors. While adenovirus and BK virus are well-known pathogens in the context of hematopoietic stem cell transplant, there are no detailed reports of these infections in the setting of CAR T-cell therapy. We describe a 70-year-old male who recently underwent CAR T-cell therapy for diffuse large B-cell lymphoma. He presented with intractable gross hematuria and dysuria. Workup revealed adenovirus viremia and viruria and BK virus viruria. He was treated for adenovirus hemorrhagic cystitis with intravenous cidofovir 1 mg/kg/day, every three days for three weeks, with good clinical response. We also discuss the mechanisms of immunosuppression in CAR T-cell therapy as well as the principles of treatment of adenovirus and BK virus infections in the immunosuppressed patient.
接受嵌合抗原受体T细胞疗法（CAR T细胞疗法）的患者由于多种因素而免疫抑制。虽然腺病毒和BK病毒在造血干细胞移植背景下是众所周知的病原体，但在CAR T细胞疗法背景下尚无这些感染的详细报告。我们描述了一名70岁男性，他最近因弥漫性大B细胞淋巴瘤接受了CAR T细胞疗法。他出现了难治性肉眼血尿和排尿困难。检查发现腺病毒血症、病毒尿症以及BK病毒尿症。他接受了静脉注射西多福韦治疗腺病毒出血性膀胱炎，剂量为1mg/kg/天，每三天一次，共三周，临床反应良好。我们还讨论了CAR T细胞疗法中的免疫抑制机制以及免疫抑制患者腺病毒和BK病毒感染的治疗原则。
