Infectious complications in pediatric patients undergoing CD19+CD22+ chimeric antigen receptor T-cell therapy for relapsed/refractory B-lymphoblastic leukemia

• DOI: 10.1007/s10238-024-01339-7
• Publication Date: 2024-04-25T10:02:14Z
• Authors: Xiaochen Wu; Zhanmeng Cao; Zihan Chen; Yi Wang; Hailong He; Peifang Xiao; Shaoyan Hu; Jun Lu; Benshang Li
• Keywords: CD22; Hematology; Refractory (planetary science); Blinatumomab

Abstract Chimeric antigen receptor T-cell (CAR-T) therapy is effective in the treatment of relapsed/refractory acute B-lymphoblastic leukemia (R/R B-ALL); however, patients who receive CAR-T are predisposed to infections, with considerable detrimental effects on long-term survival rates and quality life patients. This study retrospectively analyzed infectious complications 79 pediatric R/R B-ALL treated cells at our institution. Overall, 53 developed 88 infections. Nine experienced nine infections during lymphodepletion chemotherapy, 35 41 early phase (days 0–+ 30 after infusion), 29 38 late (day + 31–+ 90 infusion). Pathogens were identified 31 including 23 bacteria, seven viruses, one fungus. Four admitted intensive care unit for infection died. In a univariate analysis, there ten factors associated infection, tumor load, lymphodepleting neutrophil deficiency lymphocyte reduction, cytokine release syndrome (CRS) immune effector cell-associated neurotoxicity (ICANS), etc. multivariate CRS ≥ grade 3 was as risk factor (hazard ratio = 2.41, 95% confidence interval: 1.08–5.36, P 0.031). Therefore, actively reducing may decrease improve these