TY - JOUR
T1 - Chimeric antigen receptor T-cell therapy for the treatment of lymphoid malignancies
T2 - is there an excess risk for infection?
AU - Gudiol, Carlota
AU - Lewis, Russell E.
AU - Strati, Paolo
AU - Kontoyiannis, Dimitrios P.
N1 - Funding Information:
We thank Ms Laura L Russell, from the Scientific Editing Services, Research Medical Library, MD Anderson Cancer Center, for editing assistance. We thank Ms Salli Saxton for the administrative support. This Review was funded in part by the Cancer Center Support Grant (CCSG), MD Anderson Cancer Center and by the Texas 4000 Endowment (DPK). The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/3
Y1 - 2021/3
N2 - Therapy with genetically engineered chimeric antigen receptor (CAR) T cells targeting the CD19 antigen is promising for a number of refractory or relapsed B-cell malignancies. Information on the infectious complications of this immunotherapeutic strategy is scarce and difficult to interpret, as many factors influence infection incidence and outcomes. CAR T-cell therapy is usually given to patients with haematological cancers who have been heavily pretreated and are severely immunosuppressed. Moreover, the risk of infection is increased by the administration of lymphodepleting chemotherapy before CAR T-cell infusion, and by the development of complications such as cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome, which are managed with anti-interleukin-6 antibodies, or corticosteroids, or both. On-target, off-tumour toxicities, such as B-cell aplasia, hypogammaglobulinaemia, and persistent or biphasic cytopenia, are common. In this Review, we evaluate the reported infectious complications of CAR T-cell therapy and associated risk factors and offer perspectives on its infection risk.
AB - Therapy with genetically engineered chimeric antigen receptor (CAR) T cells targeting the CD19 antigen is promising for a number of refractory or relapsed B-cell malignancies. Information on the infectious complications of this immunotherapeutic strategy is scarce and difficult to interpret, as many factors influence infection incidence and outcomes. CAR T-cell therapy is usually given to patients with haematological cancers who have been heavily pretreated and are severely immunosuppressed. Moreover, the risk of infection is increased by the administration of lymphodepleting chemotherapy before CAR T-cell infusion, and by the development of complications such as cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome, which are managed with anti-interleukin-6 antibodies, or corticosteroids, or both. On-target, off-tumour toxicities, such as B-cell aplasia, hypogammaglobulinaemia, and persistent or biphasic cytopenia, are common. In this Review, we evaluate the reported infectious complications of CAR T-cell therapy and associated risk factors and offer perspectives on its infection risk.
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U2 - 10.1016/S2352-3026(20)30376-8
DO - 10.1016/S2352-3026(20)30376-8
M3 - Review article
C2 - 33460558
AN - SCOPUS:85100083313
SN - 2352-3026
VL - 8
SP - e216-e228
JO - The Lancet Haematology
JF - The Lancet Haematology
IS - 3
ER -