{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:36:08Z","timestamp":1788975368277,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>CAR T\u2010cell therapy, where a patient's own T cells are re\u2010engineered to express a receptor to a target of interest, is becoming an increasingly utilized cancer\u2010directed therapy. There are significant toxicities that contribute to a novel state of immunocompromise, leading to new patterns of infectious complications that require further detailed study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We created a single\u2010center cohort of adult recipients of CD19\u2010directed CAR T\u2010cell therapy and assessed infectious outcomes, supportive care received, toxicities, and markers of immune function up to 2 years following CAR T\u2010cell therapy. Descriptive statistics were used as appropriate for analysis. We additionally conducted time\u2010to\u2010event analysis assessing time\u2010to\u2010first infection with either log\u2010rank testing or Cox regression with univariate analysis, before including significant predictors into a multivariate Cox model of time to infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 73 patients who received CD19\u2010directed CAR T\u2010cell therapy who predominantly had diffuse large B\u2010cell lymphoma. Within 30 days of cell infusion, bacterial and <jats:italic>Candida<\/jats:italic> infections were the most common, with 64% of infections due to these organisms. Between 30 days and 2 years postinfusion, respiratory viruses and pneumonia were the most frequent infections, with 68% of infections due to these etiologies. Receipt of tocilizumab, development of immune effector cell\u2010associated neurotoxicity syndrome (ICANS), or lower neutrophil count were associated with quicker onset of infection in a multivariate Cox model.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14148-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Respiratory viruses remain an important infectious complication of CAR T\u2010cell therapy following the first year. The model may be a useful tool to identify patients at the highest risk of infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14148","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T13:44:41Z","timestamp":1694439881000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Infectious complications of car T\u2010cell therapy: A longitudinal risk model"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6566-5906","authenticated-orcid":false,"given":"Michael T.","family":"Czapka","sequence":"first","affiliation":[{"name":"Department of Medicine Section of Infectious Disease University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Riedell","sequence":"additional","affiliation":[{"name":"Department of Medicine Section of Hematology and Oncology University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C.","family":"Pisano","sequence":"additional","affiliation":[{"name":"Department of Medicine Section of Infectious Disease University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.28.1618"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512073332305"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/BLOOD\u20102017\u201003\u2010769620"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.53.9593"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1365\u20102141.2005.05603.X"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.213"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.0198"},{"key":"e_1_2_10_9_1","unstructured":"National Cancer Institute.CAR T cells: Engineering immune cells to treat cancer\u2014National Cancer Institute. 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