Infectious Complications and Preventative Strategies following Chimeric Antigen Receptor T-cells (CAR-T cells) Therapy for B-Cell Malignancies
Alfadil Haroon, Ibrahim N. Muhsen, Muhammad Bilal Abid, Abdulwahab Albabtain, Ali Alahmari, Syed Osman Ahmed, Riad El Fakih, Mahmoud Aljurf
Abstract
Several chimeric antigen receptor T-cell constructs (CAR-T cells) are currently approved for the treatment of B-cell malignancies, including non-Hodgkin lymphoma and acute lymphoblastic leukemia. Additionally, multiple other products are being investigated and developed for other hematological malignancies and solid cancers. Patients receiving CAR-T cells are at increased risk of infectious complications that lead to increased morbidity and inferior mortality in these patients. In this review, we discuss the literature on the incidence and types of infection in patients in the early and late-phase after CAR-T cells infusion. Additionally, we summarize the current literature on prophylaxis against viral, bacterial, and fungal infections after CAR-T cells infusion and the utility of preventative and supportive measures including intravenous immunoglobulins and myeloid growth factors.