Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper

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;...

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Authors: Los-Arcos, I, Iacoboni, G, Aguilar-Guisado, M, Alsina-Manrique, L, de Heredia, CD, Fortuny-Guasch, C, Garcia-Cadenas, I, Garcia-Vidal, C, Gonzalez-Vicent, M, Hernani, R, Kwon, M, Machado, M, Martinez-Gomez, X, Maldonado, VO, Pla, CP, Pinana, JL, Pomar, V, Reguera-Ortega, JL, Salavert, M, Soler-Palacin, P, Vazquez-Lopez, L, Barba, P, Ruiz-Camps, I
Format: article
Status:Published version
Publication Date:2021
Country:España
Institution:INCLIVA
Repository:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p15153
Online Access:https://incliva.portalinvestigacion.com/publicaciones/15153
Access Level:Open access
Keyword:B-cell acute lymphoblastic leukemia
Bacterial infections
Chimeric antigen receptor
Diffuse large B-cell lymphoma
Fungal infections
Viral infections
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spelling Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paperLos-Arcos, IIacoboni, GAguilar-Guisado, MAlsina-Manrique, Lde Heredia, CDFortuny-Guasch, CGarcia-Cadenas, IGarcia-Vidal, CGonzalez-Vicent, MHernani, RKwon, MMachado, MMartinez-Gomez, XMaldonado, VOPla, CPPinana, JLPomar, VReguera-Ortega, JLSalavert, MSoler-Palacin, PVazquez-Lopez, LBarba, PRuiz-Camps, IB-cell acute lymphoblastic leukemiaBacterial infectionsChimeric antigen receptorDiffuse large B-cell lymphomaFungal infectionsViral infectionsChimeric 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.SPRINGER HEIDELBERG2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/15153INFECTIONISSN: 03008126ISSNe: 14390973reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p151532026-06-07T16:35:31Z
dc.title.none.fl_str_mv Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
title Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
spellingShingle Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
Los-Arcos, I
B-cell acute lymphoblastic leukemia
Bacterial infections
Chimeric antigen receptor
Diffuse large B-cell lymphoma
Fungal infections
Viral infections
title_short Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
title_full Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
title_fullStr Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
title_full_unstemmed Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
title_sort Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper
dc.creator.none.fl_str_mv Los-Arcos, I
Iacoboni, G
Aguilar-Guisado, M
Alsina-Manrique, L
de Heredia, CD
Fortuny-Guasch, C
Garcia-Cadenas, I
Garcia-Vidal, C
Gonzalez-Vicent, M
Hernani, R
Kwon, M
Machado, M
Martinez-Gomez, X
Maldonado, VO
Pla, CP
Pinana, JL
Pomar, V
Reguera-Ortega, JL
Salavert, M
Soler-Palacin, P
Vazquez-Lopez, L
Barba, P
Ruiz-Camps, I
author Los-Arcos, I
author_facet Los-Arcos, I
Iacoboni, G
Aguilar-Guisado, M
Alsina-Manrique, L
de Heredia, CD
Fortuny-Guasch, C
Garcia-Cadenas, I
Garcia-Vidal, C
Gonzalez-Vicent, M
Hernani, R
Kwon, M
Machado, M
Martinez-Gomez, X
Maldonado, VO
Pla, CP
Pinana, JL
Pomar, V
Reguera-Ortega, JL
Salavert, M
Soler-Palacin, P
Vazquez-Lopez, L
Barba, P
Ruiz-Camps, I
author_role author
author2 Iacoboni, G
Aguilar-Guisado, M
Alsina-Manrique, L
de Heredia, CD
Fortuny-Guasch, C
Garcia-Cadenas, I
Garcia-Vidal, C
Gonzalez-Vicent, M
Hernani, R
Kwon, M
Machado, M
Martinez-Gomez, X
Maldonado, VO
Pla, CP
Pinana, JL
Pomar, V
Reguera-Ortega, JL
Salavert, M
Soler-Palacin, P
Vazquez-Lopez, L
Barba, P
Ruiz-Camps, I
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv B-cell acute lymphoblastic leukemia
Bacterial infections
Chimeric antigen receptor
Diffuse large B-cell lymphoma
Fungal infections
Viral infections
topic B-cell acute lymphoblastic leukemia
Bacterial infections
Chimeric antigen receptor
Diffuse large B-cell lymphoma
Fungal infections
Viral infections
description 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.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/15153
url https://incliva.portalinvestigacion.com/publicaciones/15153
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER HEIDELBERG
publisher.none.fl_str_mv SPRINGER HEIDELBERG
dc.source.none.fl_str_mv INFECTION
ISSN: 03008126
ISSNe: 14390973
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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