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Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up

INTRODUCTION: The rapidly developed CAR-T cell therapy has a unique profile of side effects, which perhaps has not been totally realized and understood, especially the late-phase toxicity. CMV is prevalent world-wide and establishes a life-long latency infection. It can lead to life-threatening comp...

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Autores principales: Cheng, Jiali, Huang, Jin, Cao, Wenyue, Huang, Liang, Mao, Xia, Chen, Liting, Zhou, Jianfeng, Wang, Na
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577281/
https://www.ncbi.nlm.nih.gov/pubmed/37849765
http://dx.doi.org/10.3389/fimmu.2023.1226148
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author Cheng, Jiali
Huang, Jin
Cao, Wenyue
Huang, Liang
Mao, Xia
Chen, Liting
Zhou, Jianfeng
Wang, Na
author_facet Cheng, Jiali
Huang, Jin
Cao, Wenyue
Huang, Liang
Mao, Xia
Chen, Liting
Zhou, Jianfeng
Wang, Na
author_sort Cheng, Jiali
collection PubMed
description INTRODUCTION: The rapidly developed CAR-T cell therapy has a unique profile of side effects, which perhaps has not been totally realized and understood, especially the late-phase toxicity. CMV is prevalent world-wide and establishes a life-long latency infection. It can lead to life-threatening complications in immunocompromised host, and little is known about CMV disease in patients after CAR-T cell therapy. Here, we report a patient who developed possible CMV-pneumonia three months after anti-CD19 and anti-CD22 CAR-T cell therapy for relapsed B-ALL, contributing to the understanding of severe side-effects mediated by virus infection or reactivation in patients receiving CAR-T cell infusion. CASE PRESENTATION: A 21-year old male patient with relapsed B-ALL received anti-CD19/22 CAR-T cell therapy, and achieved complete remission 2 weeks after the infusion. However, three months later, the patient was hospitalized again with a 10-day history of fever and cough and a 3-day history of palpitations and chest tightness. He was diagnosed with possible CMV pneumonia. Under treatment with antiviral medicine (ganciclovir/penciclovir), intravenous gamma globulin and methylprednisolone and the use of BiPAP ventilator, his symptoms improved, but after removing penciclovir his symptoms went out of control, and the patient died of respiratory failure 22 days after admission. CONCLUSION: CMV infection/reactivation can occur in patients long after receiving anti-CD19/22 CAR-T cell therapy, and induce fatal pneumonia, which reminds us of the late side effects associated with immunosuppression after CAR-T cell infusion.
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spelling pubmed-105772812023-10-17 Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up Cheng, Jiali Huang, Jin Cao, Wenyue Huang, Liang Mao, Xia Chen, Liting Zhou, Jianfeng Wang, Na Front Immunol Immunology INTRODUCTION: The rapidly developed CAR-T cell therapy has a unique profile of side effects, which perhaps has not been totally realized and understood, especially the late-phase toxicity. CMV is prevalent world-wide and establishes a life-long latency infection. It can lead to life-threatening complications in immunocompromised host, and little is known about CMV disease in patients after CAR-T cell therapy. Here, we report a patient who developed possible CMV-pneumonia three months after anti-CD19 and anti-CD22 CAR-T cell therapy for relapsed B-ALL, contributing to the understanding of severe side-effects mediated by virus infection or reactivation in patients receiving CAR-T cell infusion. CASE PRESENTATION: A 21-year old male patient with relapsed B-ALL received anti-CD19/22 CAR-T cell therapy, and achieved complete remission 2 weeks after the infusion. However, three months later, the patient was hospitalized again with a 10-day history of fever and cough and a 3-day history of palpitations and chest tightness. He was diagnosed with possible CMV pneumonia. Under treatment with antiviral medicine (ganciclovir/penciclovir), intravenous gamma globulin and methylprednisolone and the use of BiPAP ventilator, his symptoms improved, but after removing penciclovir his symptoms went out of control, and the patient died of respiratory failure 22 days after admission. CONCLUSION: CMV infection/reactivation can occur in patients long after receiving anti-CD19/22 CAR-T cell therapy, and induce fatal pneumonia, which reminds us of the late side effects associated with immunosuppression after CAR-T cell infusion. Frontiers Media S.A. 2023-10-02 /pmc/articles/PMC10577281/ /pubmed/37849765 http://dx.doi.org/10.3389/fimmu.2023.1226148 Text en Copyright © 2023 Cheng, Huang, Cao, Huang, Mao, Chen, Zhou and Wang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Cheng, Jiali
Huang, Jin
Cao, Wenyue
Huang, Liang
Mao, Xia
Chen, Liting
Zhou, Jianfeng
Wang, Na
Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up
title Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up
title_full Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up
title_fullStr Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up
title_full_unstemmed Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up
title_short Case Report: Fatal cytomegalovirus pneumonia after CAR-T cell therapy in the long-term follow-up
title_sort case report: fatal cytomegalovirus pneumonia after car-t cell therapy in the long-term follow-up
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577281/
https://www.ncbi.nlm.nih.gov/pubmed/37849765
http://dx.doi.org/10.3389/fimmu.2023.1226148
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