CD19嵌合抗原受体T细胞治疗后发生的伴有垂体受累及功能障碍的迟发性侵袭性曲霉病。
Late-Onset Invasive Aspergillosis With Pituitary Involvement and Dysfunction Following CD19 Chimeric Antigen Receptor T-Cell Therapy.
作者信息
Ikeda Daisuke, Nawada Tomohiro, Kondo Takumi, Shinohara Takayuki, Nagano Tomohiro, Kubota Saya, Hiyama Ryuichiro, Ueno Masaya, Kobayashi Hiroki, Seike Keisuke, Fujiwara Hideaki, Asada Noboru, Ennishi Daisuke, Fujii Keiko, Fujii Nobuharu, Makita Masanori, Maeda Yoshinobu
机构信息
Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan.
Department of Hematology and Oncology Okayama University Hospital Okayama Japan.
出版信息
EJHaem. 2025 Sep 2;6(5):e70138. doi: 10.1002/jha2.70138. eCollection 2025 Oct.
INTRODUCTION
Invasive fungal infection (IFI) after chimeric antigen receptor (CAR) T-cell therapy is less common than bacterial and viral infections, but can be fatal once it develops. As most cases occur within 30 days after CAR T-cell infusion, late-onset IFI-particularly mould infection-appears to be under-recognised.
DISCUSSION
We report an illustrative case of pituitary aspergillosis developing as late as one year after CD19 CAR T-cell therapy, highlighting a persistent risk in certain patients with delayed immune reconstitution.
CONCLUSION
This case underscores the need for continued vigilance and individualised antifungal strategies to prevent IFI beyond the early post-infusion period.
TRIAL REGISTRATION
The authors have confirmed clinical trial registration is not needed for this submission.
引言
嵌合抗原受体（CAR）T细胞治疗后的侵袭性真菌感染（IFI）比细菌和病毒感染少见，但一旦发生可能致命。由于大多数病例发生在CAR T细胞输注后的30天内，迟发性IFI（尤其是霉菌感染）似乎未得到充分认识。
讨论
我们报告了1例垂体曲霉菌病病例，该病例在CD19 CAR T细胞治疗后长达1年才出现，突出了某些免疫重建延迟患者存在的持续风险。
结论
该病例强调了在输注后早期之后仍需持续警惕并采取个体化抗真菌策略以预防IFI。
试验注册
作者已确认本投稿无需临床试验注册。
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