Cytomegalovirus infection in chimeric antigen receptor T-cell recipients

Chimeric antigen receptor (CAR) T-cell therapy is an innovative immunotherapy treatment for hematological malignancies. Some of the challenges in using this therapy are the development of cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, immunosuppression, and hypogammaglobulinemia, which can be prolonged and significantly increase patients' risk of infection. Cytomegalovirus (CMV) is well known to cause disease and organ damage in immunocompromised hosts, increasing mortality and morbidity. We present a case of a 64-year-old man with multiple myeloma with a significant history of CMV infection that worsened after CAR T-cell therapy and became challenging to contain because of prolonged cytopenias, progression of myeloma, and development of other opportunistic infections. Strategies for prophylaxis, treatment, and maintenance of CMV infections in CAR T-cell therapy recipients are further warranted.