To summarize the current knowledge on infectious complications occurring in patients receiving CAR-T cell therapy for lymphoid malignancies and provide tools for better management and prevention strategies.
Approach:
Key Findings:
Infections following CAR-T therapy exhibit a biphasic pattern: early infections within the first 30 days and late infections from day 30 onward.
Bacterial infections are predominant in the early phase, while viral and opportunistic infections are more common in the late phase.
Risk factors for infections include host-related factors (underlying malignancy, previous treatments) and treatment-related factors (CAR-T product, CRS, ICANS, hypogammaglobulinemia).
The incidence of early infections ranges from 23% to 77%, while late infections range from 14% to 61% across various studies.
Most infections reported were mild and managed in outpatient settings, with severe infections occurring in 16.2% of patients.
Interpretation:
Remove unsupported claims.
Limitations:
The real incidence of infections is difficult to assess due to the retrospective nature of studies and heterogeneous patient populations.
Many studies lack detailed data on the etiology or site of infections and whether patients received prophylaxis.
