{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T20:15:22Z","timestamp":1774642522019,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T00:00:00Z","timestamp":1701475200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>CD19\u2010directed chimeric antigen receptor T\u2010cell (CAR\u2010T) therapy is transforming care for pediatric patients with relapsed or refractory B\u2010cell acute lymphoblastic leukemia (B\u2010ALL). There are limited pediatric\u2010specific data concerning the infection risks associated with CD19 CAR\u2010T therapy and the adequacy of current antimicrobial prophylaxis guidelines for these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe the antimicrobial prophylaxis used and the types of infectious occurring in the first 100 days following CAR\u2010T therapy for relapsed or refractory B\u2010cell ALL in children and adolescents (\u226418 years) at our centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven patients received their first CAR\u2010T infusion (CTI) during the study period. Almost all patients (96%) had a comprehensive Infectious Diseases review prior to CTI, which informed a personalised prophylaxis or fever\/sepsis plan in six (22%). Overall, six (22%) patients had one or more infections during the study period including five (19%, 0.9 per 100 days\u2010at\u2010risk) from days 0\u201330 and three (<jats:italic>n<\/jats:italic> = 20, 15%, 0.6 per 100 days\u2010at\u2010risk) from days 31\u2013100. Bacterial blood stream infections were the most common type of infection encountered during both time periods, and one patient had probable pulmonary aspergillosis. There were no infection\u2010related deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study contributes important information on the spectrum of infections encountered in pediatric patients with B\u2010ALL post CAR\u2010T therapy. Overall, the burden of infectious complications post CAR\u2010T therapy in our cohort is lower than previously reported in the literature. Results suggest that our prophylaxis recommendations are effective in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14202","type":"journal-article","created":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T20:38:35Z","timestamp":1701549515000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Infections in children following chimeric antigen receptor T\u2010cell therapy for B\u2010cell acute lymphoblastic leukemia"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6824-8367","authenticated-orcid":false,"given":"Yonatan","family":"Diamond","sequence":"first","affiliation":[{"name":"Kids Cancer Centre, Sydney Children's Hospital  Randwick New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maddie","family":"Gilsenan","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacie Shiqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"},{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Hanna","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"},{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Conyers","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"},{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Cole","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Hughes","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Fleming","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Meyran","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Toro","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"},{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"},{"name":"Paediatric Integrated Cancer Service  Victoria Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vajiranee","family":"Malalasekera","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong Lin","family":"Khaw","sequence":"additional","affiliation":[{"name":"Children's Cancer Centre, Royal Children's Hospital  Parkville Victoria Australia"},{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle M.","family":"Haeusler","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"},{"name":"Paediatric Integrated Cancer Service  Victoria Victoria Australia"},{"name":"Department of Infectious Diseases Royal Children's Hospital  Parkville Victoria Australia"},{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1407222"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14205022"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.229781"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.845540"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000679"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25335"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1008"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.758"},{"key":"e_1_2_9_10_1","unstructured":"Royal Children's Hospital.Clinical practice guidelines: antifungal prophylaxis for children with cancer or undergoing haematopoietic stem cell transplant 2023. Accessed August 4 2023.https:\/\/www.rch.org.au\/clinicalguide\/guideline_index\/Antifungal_prophylaxis_for_children_with_cancer_or_undergoing_haematopoietic_stem_cell_transplant\/"},{"key":"e_1_2_9_11_1","unstructured":"Royal Children's Hospital.Clinical practice guidelines: fever and suspected or confirmed neutropenia 2023. Accessed August 4 2023.https:\/\/www.rch.org.au\/clinicalguide\/guideline_index\/Fever_and_suspected_or_confirmed_neutropenia\/"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-07-793760"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa121"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709866"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-022-01756-w"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T17:16:30Z","timestamp":1704647790000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.14202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/tid.14202"],"URL":"https:\/\/doi.org\/10.1111\/tid.14202","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]},"assertion":[{"value":"2023-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14202"}}