Factors associated with increased risk of infection in CAR-T recipients
Muhammad Bilal Abid, MD, MRCP, Medical College of Wisconsin, Milwaukee, WI, discusses the association between durable responses to chimeric antigen receptor T-cell (CAR-T) therapy and increased risk of infection. Whilst increasingly sophisticated CAR-T constructs are being developed to prolong survival, Dr Abid describes how they are also associated with an increased rate of viral and fungal infections. The risk of infections with CAR-T depends on both factors related to the CAR-T constructs and factors associated with interventions performed in the peri-treatment period, including lymphodepletion chemotherapy, interval between leukapheresis and infusion, bridging therapy, CAR T-cell dose, types of intracellular signaling and costimulatory domains, and target antigens. In addition, common CAR-T-induced toxicities such as cytokine release syndrome (CRS) and neurotoxicity, as well as rarer long-term toxicities including B-cell aplasia, cytopenia and hypogammaglobulinemia, further predispose patients to infections. This interview was recorded virtually.
