Infectious complications and preventative strategies following Chimeric Antigen Receptor T-cells (CAR-T cells) therapy for B-cell malignancies

Features and outcomes of patients admitted to the ICU for chimeric antigen receptor T cell-related toxicity: a French multicentre cohort

“…Among 238 patients given CAR-T therapy, 84 (35.3%) required ICU admission and were included in the study, a median of 5 [0-7] days after CAR-T infusion. Median SOFA and SAPSII scores were 3 [2-6] and 39 [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], respectively. Criteria for cytokine release syndrome were met in 80/84 (95.2%) patients, including 18/80 (22.5%) with grade 3-4 toxicity.…”

“…Three of our patients had fungal infections. The optimal prophylactic or pre-emptive strategy for infection after CAR-T therapy has yet to be determined but as of now, urgent broad-spectrum antibiotics in all febrile patients with neutropenia remain essential [ 37 , 38 ].…”

“…The main reasons for ICU admission (97 stays) were neurological failure (36.1%), haemodynamic instability (29.9%), and close monitoring (34%). Median SOFA and SAPSII scores were 3 [2][3][4][5][6] and 39 [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], respectively. Most patients had few non-malignant comorbidities and were in good general health, with 92.7% having a performance status of 0-2.…”

Protracted viral infections in patients with multiple myeloma receiving bispecific T-cell engager therapy targeting B-cell maturation antigen

“…Given significant risk of infections with prolonged use, examining BiTE therapies for RRMM on protocols with fixed duration or intermittent dosing are urgently needed. Meanwhile, comprehensive infection prevention strategies are urgently needed, particularly in patients with durable remission on ongoing therapy 15 .…”

“…Meanwhile, comprehensive infection prevention strategies are urgently needed, particularly in patients with durable remission on ongoing therapy. 15 …”