{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T14:06:05Z","timestamp":1781100365311,"version":"3.54.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CM25\/00065"],"award-info":[{"award-number":["CM25\/00065"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","award":["FIS PI24\/01776"],"award-info":[{"award-number":["FIS PI24\/01776"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","award":["PI24\/01776"],"award-info":[{"award-number":["PI24\/01776"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cytokine release syndrome (CRS) and immune effector cell\u2013associated neurotoxicity syndrome (ICANS) are common toxicities after chimeric antigen receptor (CAR) T-cell therapy. We evaluated the incidence, timing, microbiology, and risk factors of microbiologically documented infections during the CRS and\/or ICANS phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Consecutive adults receiving CAR T-cell therapy between 2020 and 2023 were retrospectively analyzed. Infections were classified by type and timing. The 60-day cumulative incidence of first infection and associated factors were assessed using Fine\u2013Gray competing-risk models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 152 CAR T-cell infusions, CRS and\/or ICANS occurred in 117 (77.0%) episodes, and 70 (59.8%) required immunomodulatory therapy. An infectious etiology was documented in 30 (25.6%) episodes, yielding 45 documented infections (21 bacterial [46.7%], 17 viral [37.8%], and 7 fungal [15.6%]), more frequent in immunomodulatory-treated episodes (32.9% vs 14.9%; P = .033). At infection onset, median temperature, and C-reactive protein (CRP) levels were lower than at CRS\/ICANS diagnosis (37.2\u00b0C vs 38.4\u00b0C; P &amp;lt; .001 and 3.9 vs 6.0\u2005mg\/L; P = .002). In immunomodulatory-treated episodes, median time to first infection was 15 (7\u201322) days from CRS and 9 (5\u201320) days from ICANS. The 60-day cumulative infection incidence was 60.0% with multimodal immunosuppression and 20.8% without; multimodal immunosuppression independently increased infection risk (subdistribution hazard ratio [sHR] 3.29; 95% CI 1.38\u20137.82; P = .007).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CRS\/ICANS phase carries a high risk of bacterial, viral, and fungal infections, particularly under multimodal immunosuppression, while fever and CRP are unreliable indicators. Focused strategies for early detection, prevention, and prompt treatment of infections are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag274","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:33:42Z","timestamp":1781004822000},"source":"Crossref","is-referenced-by-count":0,"title":["Infections in Patients With Cytokine Release Syndrome\/Immune Effector Cell\u2013Associated Neurotoxicity Syndrome Following Chimeric Antigen Receptor T-Cell Therapy"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1517-4073","authenticated-orcid":false,"given":"Antonio","family":"Gallardo-Pizarro","sequence":"first","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona \u2013 Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6638-1697","authenticated-orcid":false,"given":"Miquel","family":"Ari\u00f1o","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona \u2013 Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5101-9420","authenticated-orcid":false,"given":"Carlos","family":"Lopera","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona \u2013 Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , Barcelona 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