Infectious complications of CD19-targeted chimeric antigen receptor T-cell therapy: a multicenter cohort study

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ID: 319594
2026
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Abstract
Abstract Background Our understanding of the epidemiology of and risk factors for post-chimeric antigen receptor T-cell therapy (CART) infections is largely based on data from single-center studies with small sample sizes. Methods This is a multicenter, cohort study of adult patients treated with CD19 CART between January 1, 2018 and August 31, 2021. The epidemiology of infectious complications occurring within the first year after CART is described. A Fine-Gray subdistribution hazard model was built to identify risk factors for infection. Logistic regression was used to explore risk factors for early (≤90 days post-CART) vs late (>90 days post-CART) and bacterial vs viral infection. Results 131 infections occurred in 97 of 311 patients (31.2%) within one year of CART. By infection type, the cumulative incidence of infection was 19.0% (viral), 20.9% (bacterial), and 2.3% (fungal). The majority of infections were mild or moderate in severity (86%). Clostridiodes difficile and bloodstream infections due to Gram-negative bacilli were common bacterial infections. Respiratory viral infections were the most common viral complication and fungal infections were rare. No independent predictors of infection were identified. Conclusions Infectious complications occur in close to a third of patients post-CART, but are generally mild in severity. Though we were not able to identify independent predictors of post-CART infection, a description of their clinical characteristics and epidemiology will help to optimize management of these common complications.
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Authors Jonathan Huggins, Julia A. Messina, Jennifer Saullo, Jiayi Xie, Amy Zhang, Ishan Paranjpe, Rong Lu, Megan Walsh, Michael Mohnasky, Joseph Stromberg, Felicia Cao, Natalie S. Grover, Manish Saha, Alicia Darwin, Nancy Torres, Patrick Tam, Daniel Schrum, Erin Eberwein, Erin Kennedy, Christopher R Kelsey, Taewoong Choi, Matthew McKinney, Yubin Kang, Melody Smith, Tessa M. Andermann
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag423
URL
https://doi.org/10.1093/ofid/ofag423
Keywords Keywords not found

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