After the fog has lifted: infections with CD19 CAR-T therapy

In this issue of Blood Advances, Wudhikarn et al 1 report on the incidence, types, risk factors, and outcomes of clinically significant infections (CSIs) within the first 100 days after the first infusion of CD19 chimeric antigen receptor (CAR) T-cell therapy (eg, axicabtagene ciloleucel or tisagenlecleucel) for the treatment of relapsed/refractory (R/R) large B-cell lymphoma (LBCL).This large retrospective observational study that spanned almost 5 years (December 2017 to June 2022) revealed a concerningly high incidence of at least 1 CSI (24.9%; n = 834) with a 100-day infection-related mortality of 1.6% (95% confidence interval, 1.2-2.0).Furthermore, infection within the first 100 days after receiving CD19 CAR T-cell therapy was identified as an independent risk factor for reduced overall longer-term survival (ie, beyond 100 days of CAR T-cell therapy). 1