Old Pathogens–New Patient Types: Infections in a CAR T‐Cell Recipient. Could It Get Any More Complicated?

The case discussed involves a 41-year-old Italian man who was a candidate for chimeric antigen receptor T-cell therapy (CAR-T) for mediastinal diffuse large B-cell lymphoma. His CAR-T treatment was postponed several times due to prolonged relapsing COVID-19 and new onset of pulmonary Mycobacterium tuberculosis diseases. After 11 weeks of antimycobacterial treatment, CAR T-cell therapy was performed, but complicated by cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Two months after CAR-T, the patient developed invasive pulmonary aspergillosis due to A. fumigatus. He was successfully treated with a 6-month course of antitubercular therapy and an 8-month course of antifungal therapy with isavuconazole. Lobectomy was performed due to episodes of severe hemoptysis. The challenging issues of diagnosis, choice, and management of treatments, including drug-drug interactions and length of therapy, are discussed.

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Publication Details

Journal
Transplant Infectious Disease
Published
2025-08-21
DOI
https://doi.org/10.1111/tid.70093
Citations
1
Primary Topic
CAR-T cell therapy research
Type
article
Field-Weighted Citation Impact
1.05
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article

Old Pathogens–New Patient Types: Infections in a CAR T‐Cell Recipient. Could It Get Any More Complicated?

Laurel A. Thur, Dionysios Neofytos, Anna Maria Raiola, Monica Melchio et al.
1 citations
Transplant Infectious Disease
CAR-T cell therapy research
1.05
article

Old Pathogens–New Patient Types: Infections in a CAR T‐Cell Recipient. Could It Get Any More Complicated?

Laurel A. Thur, Dionysios Neofytos, Anna Maria Raiola, Monica Melchio, Emanuele Delfino, Małgorzata Mikulska, Matteo Bassetti, Massimiliano Gambella, Elisa Balletto, Emanuele Angelucci, Maunank Shah
article en
1 citations

Abstract

The case discussed involves a 41-year-old Italian man who was a candidate for chimeric antigen receptor T-cell therapy (CAR-T) for mediastinal diffuse large B-cell lymphoma. His CAR-T treatment was postponed several times due to prolonged relapsing COVID-19 and new onset of pulmonary Mycobacterium tuberculosis diseases. After 11 weeks of antimycobacterial treatment, CAR T-cell therapy was performed, but complicated by cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Two months after CAR-T, the patient developed invasive pulmonary aspergillosis due to A. fumigatus. He was successfully treated with a 6-month course of antitubercular therapy and an 8-month course of antifungal therapy with isavuconazole. Lobectomy was performed due to episodes of severe hemoptysis. The challenging issues of diagnosis, choice, and management of treatments, including drug-drug interactions and length of therapy, are discussed.

Transplant Infectious DiseaseVol. 27(5)
Johns Hopkins University (US), University of Washington (US), Johns Hopkins Medicine (US), Fred Hutch Cancer Center (US), University Hospital of Geneva (CH), Istituto Nazionale di Fisica Nucleare, Sezione di Genova (IT), Ospedale Policlinico San Martino (IT), Geneva College (US), University of Genoa (IT)
Openalex Percentile: Top 19%
CAR-T cell therapy research
1.05
DOIOpen Access PDFOpenAlex
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