RT Journal Article
T1 Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper.
A1 Los-Arcos, Ibai
A1 Iacoboni, Gloria
A1 Aguilar-Guisado, Manuela
A1 Alsina-Manrique, Laia
A1 Díaz de Heredia, Cristina
A1 Fortuny-Guasch, Claudia
A1 García-Cadenas, Irene
A1 García-Vidal, Carolina
A1 González-Vicent, Marta
A1 Hernani, Rafael
A1 Kwon, Mi
A1 Machado, Marina
A1 Martínez-Gómez, Xavier
A1 Maldonado, Valentín Ortiz
A1 Pla, Carolina Pinto
A1 Piñana, José Luis
A1 Pomar, Virginia
A1 Reguera-Ortega, Juan Luis
A1 Salavert, Miguel
A1 Soler-Palacín, Pere
A1 Vázquez-López, Lourdes
A1 Barba, Pere
A1 Ruiz-Camps, Isabel
K1 B-cell acute lymphoblastic leukemia
K1 Bacterial infections
K1 Chimeric antigen receptor
K1 Diffuse large B-cell lymphoma
K1 Fungal infections
K1 Viral infections
AB Chimeric antigen receptor (CAR) T-cell therapy is one of the most promising emerging treatments for B-cell malignancies. Recently, two CAR T-cell products (axicabtagene ciloleucel and tisagenlecleucel) have been approved for patients with aggressive B-cell lymphoma and acute lymphoblastic leukemia; many other CAR-T constructs are in research for both hematological and non-hematological diseases. Most of the patients receiving CAR-T therapy will develop fever at some point after infusion, mainly due to cytokine release syndrome (CRS). The onset of CRS is often indistinguishable from an infection, which makes management of these patients challenging. In addition to the lymphodepleting chemotherapy and CAR T cells, the treatment of complications with corticosteroids and/or tocilizumab increases the risk of infection in these patients. Data regarding incidence, risk factors and prevention of infections in patients receiving CAR-T cell therapy are scarce. To assist in patient care, a multidisciplinary team from hospitals designated by the Spanish Ministry of Health to perform CAR-T therapy prepared these recommendations. We reviewed the literature on the incidence, risk factors, and management of infections in adult and pediatric patients receiving CAR-T cell treatment. Recommendations cover different areas: monitoring and treatment of hypogammaglobulinemia, prevention, prophylaxis, and management of bacterial, viral, and fungal infections as well as vaccination prior and after CAR-T cell therapy.
YR 2020
FD 2020-09-26
LK http://hdl.handle.net/10668/16319
UL http://hdl.handle.net/10668/16319
LA en
DS RISalud
RD Apr 18, 2025