{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:14:12Z","timestamp":1763748852443,"version":"3.37.3"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81300410","81873444","82170223"],"award-info":[{"award-number":["81300410","81873444","82170223"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Chimeric antigen receptor T-cell therapy (CAR-T) has yielded unprecedented efficacy in B-cell malignancies. With the increasing use of CAR-T-cell therapy, infection has become one of the major concerns after CAR-T-cell infusion. Some patients even develop refractory or recurrent infections, posing challenges in treatment, prophylactic, and monitoring strategies. However, the mechanisms underlying the development of these infections were not clear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report two cases of infection after CAR-T-cell therapy. Patient 1, diagnosed with multiple myeloma, received anti-B-cell maturation antigen (BCMA) chimeric antigen receptor T (CAR-T)-cell therapy. He developed a refractory urinary infection lasting for over 5\u2009weeks, which was caused by <jats:italic>Candida albicans<\/jats:italic>. Whole-exome sequencing revealed that he had an IL-17RA gene mutation. Patient 2, diagnosed with acute lymphoblastic B-cell leukaemia, received anti-CD19 and anti-CD22 CAR-T-cell cocktail therapy and remained in complete remission for over 4\u2009years. The patient had pneumonia five times during the 4\u2009years. Whole-exon sequencing revealed that he had a CX3CR1 gene mutation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>For patients who develop persistent or recurrent infections after CAR-T-cell therapy, it is recommended to screen for immunodeficiency-related gene mutations, and the results may contribute to the management of infections post-CAR-T treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-023-08070-w","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T15:04:20Z","timestamp":1677078260000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mutations in immunodeficiency-related genes may increase the risk of infection after CAR-T-cell therapy: a report of two cases"],"prefix":"10.1186","volume":"23","author":[{"given":"Di","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunhui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menglei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuxia","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varlene Daniela Fernandes","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimei","family":"Que","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanjie","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunrui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"8070_CR1","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1182\/blood-2018-99-113714","volume":"132","author":"L Huang","year":"2018","unstructured":"Huang L, Wang N, Cao Y, et al. CAR22\/19 cocktail therapy for patients with refractory\/relapsed B-cell malignancies. Blood. 2018;132:1408.","journal-title":"Blood"},{"issue":"21","key":"8070_CR2","doi-asserted-by":"publisher","first-page":"2890","DOI":"10.1182\/blood.2020008936","volume":"137","author":"D Wang","year":"2021","unstructured":"Wang D, Wang J, Hu G, et al. A phase 1 study of a novel fully human BCMA-targeting CAR (CT103A) in patients with relapsed\/refractory multiple myeloma. Blood. 2021;137(21):2890\u2013901.","journal-title":"Blood"},{"issue":"8","key":"8070_CR3","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1182\/blood.2019004000","volume":"136","author":"JA Hill","year":"2020","unstructured":"Hill JA, Seo SK. How I prevent infections in patients receiving CD19-targeted chimeric antigen receptor T cells for B-cell malignancies. Blood. 2020;136(8):925\u201335.","journal-title":"Blood"},{"issue":"6","key":"8070_CR4","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1080\/14787210.2021.1855143","volume":"19","author":"O Bupha-Intr","year":"2021","unstructured":"Bupha-Intr O, Haeusler G, Chee L, Thursky K, Slavin M, Teh B. CAR-T cell therapy and infection: a review. Expert Rev Anti Infect Ther. 2021;19(6):749\u201358.","journal-title":"Expert Rev Anti Infect Ther"},{"key":"8070_CR5","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1007\/s13402-021-00593-1","volume":"44","author":"M Akhoundi","year":"2021","unstructured":"Akhoundi M, Mohammadi M, Sahraei SS, et al. CAR T cell therapy as a promising approach in cancer immunotherapy: challenges and opportunities. Cell Oncol. 2021;44:495\u2013523.","journal-title":"Cell Oncol"},{"issue":"4","key":"8070_CR6","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1093\/cid\/ciy152","volume":"67","author":"JH Park","year":"2018","unstructured":"Park JH, Romero FA, Taur Y, et al. Cytokine release syndrome grade as a predictive marker for infections in patients with relapsed or refractory B-cell acute lymphoblastic leukemia treated with chimeric antigen receptor T cells. Clin Infect Dis. 2018;67(4):533\u201340.","journal-title":"Clin Infect Dis"},{"key":"8070_CR7","doi-asserted-by":"publisher","first-page":"5290","DOI":"10.1182\/bloodadvances.2021004603","volume":"5","author":"Y Wang","year":"2021","unstructured":"Wang Y, Li C, Xia J, et al. Humoral immune reconstitution after anti-BCMA CAR-T cell therapy in relapse\/refractory multiple myeloma. Blood Adv. 2021;5:5290\u20139.","journal-title":"Blood Adv"},{"issue":"2","key":"8070_CR8","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s15010-020-01521-5","volume":"49","author":"I Los-Arcos","year":"2021","unstructured":"Los-Arcos I, Iacoboni G, Aguilar-Guisado M, et al. Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper. Infection. 2021;49(2):215\u201331.","journal-title":"Infection"},{"issue":"10","key":"8070_CR9","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1038\/s41408-021-00563-8","volume":"11","author":"D Wang","year":"2021","unstructured":"Wang D, Mao X, Que Y, et al. Viral infection\/reactivation during long-term follow-up in multiple myeloma patients with anti-BCMA CAR therapy. 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Proc Natl Acad Sci USA. 2016;113(51):E8277\u201385.","journal-title":"Proc Natl Acad Sci USA"},{"issue":"Suppl 1","key":"8070_CR12","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/S0001-7310(14)70016-X","volume":"105","author":"Y Ling","year":"2014","unstructured":"Ling Y, Puel A. IL-17 and infections. Actas Dermosifiliogr. 2014;105(Suppl 1):34\u201340.","journal-title":"Actas Dermosifiliogr"},{"issue":"2","key":"8070_CR13","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1517\/14728220903540265","volume":"14","author":"JG D\u2019Haese","year":"2010","unstructured":"D\u2019Haese JG, Demir IE, Friess H, Ceyhan GO. Fractalkine\/CX3CR1: why a single chemokine-receptor duo bears a major and unique therapeutic potential. Expert Opin Ther Targets. 2010;14(2):207\u201319.","journal-title":"Expert Opin Ther Targets"},{"key":"8070_CR14","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/978-1-4939-9882-1_5","volume-title":"Type 2 diabetes methods and protocols","author":"MC Mahajan","year":"2020","unstructured":"Mahajan MC, McLellan AS. Whole-exome sequencing (WES) for illumina short read sequencers using solution-based capture. In: Stocker CJ, editor. Type 2 diabetes methods and protocols, vol. 2076. 2nd ed. New York: Humana Press; 2020. p. 85\u2013108.","edition":"2"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-023-08070-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-023-08070-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-023-08070-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T15:04:33Z","timestamp":1677078273000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-023-08070-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,22]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["8070"],"URL":"https:\/\/doi.org\/10.1186\/s12879-023-08070-w","relation":{},"ISSN":["1471-2334"],"issn-type":[{"type":"electronic","value":"1471-2334"}],"subject":[],"published":{"date-parts":[[2023,2,22]]},"assertion":[{"value":"6 November 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 February 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The two patients in this study were enrolled in clinical trials registered at  with registry number ChiCTR1800018137 (for patient 1) and ChiCTR-OPN-16008526 (for patient 2), both conducted at the Department of Hematology of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in China. This study was approved by the Medical Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology. Both patients gave their written informed consents to participate in the CAR-T study. All methods were carried out in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent to publish was obtained from the participant to report individual patient data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors: no reported conflicts of interest. All authors have submitted the ICMJE form for disclosure of potential conflicts of interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"109"}}