Bindal P, Trottier C A, Elavalakanar P, Dodge L E, Kim S, Logan E, Ma S, Liegel J, Arnason J, Alonso C D
Division of Oncology, Department of Medicine, University of Massachusetts, Worcester, Massachusetts, USA.
Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
Leuk Lymphoma. 2025 Apr;66(4):702-712. doi: 10.1080/10428194.2024.2439513. Epub 2024 Dec 20.
Despite increasing utilization of CAR T-cell therapy, data are lacking regarding long term follow up and risk of infectious complications after the early period following CAR T-cell infusion. In this study, we sought to compare epidemiology and risk factors for early (≤ 3 months) and late (3 months to 1 year) infections. Data were retrospectively collected at six time points: pre-CAR T, day of infusion, and at 3, 6, 9, and 12 months post CAR-T infusion for all consecutive adult patients treated at our institution. In this cohort, the cumulative incidence of any infection was 73.2% in the first year. Bridging therapy, CRS, neurotoxicity and steroid use were identified as contributing risk factors for early bacterial infections. After 3 months, community acquired respiratory infections were common. We characterize bacterial, viral and fungal pathogens based on time elapsed after CAR T-cell infusion.
尽管嵌合抗原受体（CAR）T细胞疗法的应用日益广泛，但关于CAR T细胞输注后早期阶段的长期随访和感染并发症风险的数据仍然匮乏。在本研究中，我们试图比较早期（≤3个月）和晚期（3个月至1年）感染的流行病学和危险因素。我们对在本机构接受治疗的所有连续成年患者，在六个时间点进行回顾性数据收集：CAR T治疗前、输注当天以及CAR-T输注后3、6、9和12个月。在这个队列中，第一年任何感染的累积发生率为73.2%。桥接治疗、细胞因子释放综合征（CRS）、神经毒性和类固醇使用被确定为早期细菌感染的促成危险因素。3个月后，社区获得性呼吸道感染很常见。我们根据CAR T细胞输注后的时间来描述细菌、病毒和真菌病原体。
