Infectious Complications of CD19-targeted Chimeric Antigen Receptor T-cell Therapy: a Multicenter Cohort Study

Area of Science:

• Oncology
• Immunology
• Infectious Diseases

Background:

• Current understanding of post-chimeric antigen receptor T-cell (CART) therapy infections relies on limited single-center data.
• Limited sample sizes hinder comprehensive analysis of infection epidemiology and risk factors.

Purpose of the Study:

• To describe the epidemiology of infectious complications within one year following CD19 CART.
• To identify risk factors associated with post-CART infections.
• To explore predictors of early versus late and bacterial versus viral infections.

Main Methods:

• Multicenter cohort study of adult patients receiving CD19 CART between January 2018 and August 2021.
• Descriptive epidemiology of infectious complications.
• Fine-Gray subdistribution hazard models and logistic regression to identify risk factors.

Main Results:

• 31.2% of patients (97/311) experienced 131 infections within one year post-CART.
• Cumulative incidence: 19.0% viral, 20.9% bacterial, 2.3% fungal.
• Most infections were mild/moderate (86%); common infections included Clostridioides difficile, Gram-negative bacilli bloodstream infections, and respiratory viral infections. No independent predictors were found.

Conclusions:

• Infectious complications are common but generally mild after CART.
• While independent predictors were not identified, understanding infection characteristics is crucial for optimizing patient management.
• Further research may refine risk stratification and preventive strategies.