{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T19:35:16Z","timestamp":1793907316810,"version":"4.8.0"},"reference-count":58,"publisher":"American Society of Hematology","issue":"16","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,8,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>CAR T-cell therapy has revolutionized the treatment of hematologic malignancies, although its use may be complicated by toxicities, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and infections. Invasive fungal disease (IFD) has been reported after CAR T-cell therapy, but the incidence in the absence of antifungal prophylaxis is unknown. Optimal prophylaxis strategies are widely debated. We performed a single-center retrospective study of 280 adults receiving CD19 CAR T-cell therapy for non-Hodgkin lymphoma (NHL) from December 2017 through September 2021. Patients did not receive routine antiyeast or antimold prophylaxis. IFD was identified between day of cell infusion and last follow-up. Cumulative incidence functions were calculated at 100 days and 18 months based on time to IFD, using dates of IFD-free death, initiation of salvage treatment, and hematopoietic cell transplantation as competing risks. Eight patients (2.9%) developed IFD, including 3 Pneumocystis jirovecii pneumonia, 3 invasive mold infections (IMIs), and 2\u00a0invasive yeast infections (IYIs). The 100-day cumulative incidence of IFD accounting for competing risks was 1.8% (95%\u00a0confidence interval [CI], 0.8% to 4.4%). Among the 280 patients, early toxicities including CRS (85%) and ICANS (55%) and late toxicities after day 30 including grades 3\u00a0and 4 neutropenia (41%) and low CD4 T-cell count (20%) were common. IFD was rare among patients who received CD19 CAR T-cell therapy for NHL in the absence of routine antifungal prophylaxis, despite frequent toxicities. These results suggest that, in settings with low institutional rates of IFD, routine antifungal prophylaxis may not be indicated.<\/jats:p>","DOI":"10.1182\/bloodadvances.2022007474","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T16:02:06Z","timestamp":1657296126000},"page":"4821-4830","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":75,"title":["Low incidence of invasive fungal disease following CD19 chimeric antigen receptor T-cell therapy for non-Hodgkin lymphoma"],"prefix":"10.1182","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8093-5647","authenticated-orcid":false,"given":"Jessica S.","family":"Little","sequence":"first","affiliation":[{"name":"1Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, MA;"},{"name":"2Harvard Medical School, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-5122","authenticated-orcid":false,"given":"Muneerah M.","family":"Aleissa","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"},{"name":"4Department of Pharmacy, Brigham and Women\u2019s Hospital, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Beluch","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel H.","family":"Gonzalez-Bocco","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, MA;"},{"name":"2Harvard Medical School, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco M.","family":"Marty","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, MA;"},{"name":"2Harvard Medical School, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9295-0035","authenticated-orcid":false,"given":"Jennifer","family":"Manne-Goehler","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, MA;"},{"name":"2Harvard Medical School, Boston, MA;"},{"name":"5Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Koo","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, Brigham and Women\u2019s Hospital, Boston, MA;"},{"name":"2Harvard Medical School, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah P.","family":"Hammond","sequence":"additional","affiliation":[{"name":"2Harvard Medical School, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"},{"name":"5Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA; and"},{"name":"6Division of Hematology and Oncology, Massachusetts General Cancer Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caron A.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"2Harvard Medical School, Boston, MA;"},{"name":"3Stem Cell Transplant and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"issue":"26","key":"2022081815223153600_B1","doi-asserted-by":"crossref","first-page":"2531","DOI":"10.1056\/NEJMoa1707447","article-title":"Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma","volume":"377","author":"Neelapu","year":"2017","journal-title":"N Engl J Med."},{"issue":"1","key":"2022081815223153600_B2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S1470-2045(18)30864-7","article-title":"Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1-2 trial","volume":"20","author":"Locke","year":"2019","journal-title":"Lancet 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