Human herpesvirus 6 myelitis after chimeric antigen receptor T-cell therapy

Guy Handley, Fareed Khawaja, Divya S. Kondapi, Hun J. Lee, Gregory P. Kaufman, Sattva S. Neelapu, Luis E. Fayad, Sudhakar Tummala, Linda Chi, Paolo Strati, Victor E. Mulanovich

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

This article reports a fatal case of human herpesvirus 6 (HHV-6) myelitis following CD19-targeted chimeric antigen receptor T-cell therapy. Infection from HHV-6 reactivation after haematopoietic stem cell transplant is established, and outside of this population is limited to case reports. The patient developed cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome that responded to corticosteroids both clinically and on imaging. Subsequently, ascending flaccid paralysis developed, leading to neuromuscular respiratory failure and, ultimately, death. Disease progression was refractory to foscarnet and multiple immunomodulating agents. HHV-6 should be considered in patients with encephalitis and myelitis after adoptive T-cell therapy.

Original languageEnglish (US)
Pages (from-to)327-329
Number of pages3
JournalInternational Journal of Infectious Diseases
Volume112
DOIs
StatePublished - Nov 2021

Keywords

  • CAR T-cell therapy
  • Human herpesvirus-6
  • Myelitis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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