{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:39:12Z","timestamp":1792075152365,"version":"4.4.0"},"reference-count":75,"publisher":"SAABRON PRESS","issue":"2","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Chimeric antigen receptor T-cell (CAR T-cell) therapy has changed the paradigm of management of non-Hodgkin\u2019s lymphoma (NHL) and Multiple Myeloma. Infection complications have emerged as a concern that can arise in the setting of therapy and lead to morbidity and mortality.<\/jats:p>\n                  <jats:p>In this review, we classified infection complications into three categories, pre-infusion phase from the time pre- lymphodepletion (LD) up to day zero, early phase from day of infusion to day 30 post-infusion, and late phase after day 30 onwards. Infections arising in the pre-infusion phase are closely related to previous chemotherapy and bridging therapy. Infections arising in the early phase are more likely related to LD chemo and the expected brief period of grade 3-4 neutropenia. Infections arising in the late phase are particularly worrisome because they are associated with adverse risk features including prolonged neutropenia, dysregulation of humoral and adaptive immunity with lymphopenia, hypogammaglobinemia, and B cell aplasia. Bacterial, respiratory and other viral infections, protozoal and fungal infections can occur during this time . We recommend enhanced supportive care including prompt recognition and treatment of neutropenia with growth factor support, surveillance testing for specific viruses in the appropriate instance, management of hypogammaglobulinemia with repletion as appropriate and extended antimicrobial prophylaxis in those at higher risk (e.g.\u00a0high dose steroid use and prolonged cytopenia). Finally, we recommend re-immunizing patients post CAR-T based on CDC and transplant guidelines.<\/jats:p>","DOI":"10.46989\/001c.115932","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T15:48:56Z","timestamp":1714405736000},"source":"Crossref","is-referenced-by-count":18,"title":["Managing Infection Complications in the Setting of Chimeric Antigen Receptor T cell (CAR-T) Therapy"],"prefix":"10.46989","volume":"6","author":[{"given":"Nausheen","family":"Ahmed","sequence":"first","affiliation":[{"name":"University of Kansas Cancer Center","department":["Hematologic Malignancies and Cellular Therapeutics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olalekan","family":"Oluwole","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05dq2gs74","id-type":"ROR","asserted-by":"publisher"}],"name":"Vanderbilt University Medical Center","department":["Medicine, Hematology and Oncology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Mahmoudjafari","sequence":"additional","affiliation":[{"name":"University of Kansas Cancer Center","department":["Hematologic Malignancies and Cellular Therapeutics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid","family":"Suleman","sequence":"additional","affiliation":[{"name":"University of Kansas Cancer Center","department":["Hematologic Malignancies and Cellular Therapeutics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P","family":"McGuirk","sequence":"additional","affiliation":[{"name":"University of Kansas Cancer Center","department":["Hematologic Malignancies and Cellular Therapeutics"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"26435","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1038\/s41409-022-01756-w","article-title":"Infectious complications, immune reconstitution, and infection prophylaxis after CD19 chimeric antigen receptor T-cell therapy","volume":"57","author":"Kitsada Wudhikarn","year":"2022","journal-title":"Bone Marrow Transplantation","ISSN":"https:\/\/id.crossref.org\/issn\/0268-3369","issn-type":"print"},{"issue":"8","key":"ref2","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1038\/s41408-020-00346-7","article-title":"Infection during the first year in patients treated with CD19 CAR T cells for diffuse large B cell lymphoma","volume":"10","author":"Kitsada Wudhikarn","year":"2020","journal-title":"Blood Cancer Journal","ISSN":"https:\/\/id.crossref.org\/issn\/2044-5385","issn-type":"print"},{"issue":"4","key":"ref3","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1093\/cid\/ciy152","article-title":"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","volume":"67","author":"Jae H Park","year":"2018","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"issue":"12","key":"ref4","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/j.jtct.2021.09.016","article-title":"State of the CAR-T: Risk of Infections with Chimeric Antigen Receptor T-Cell Therapy and Determinants of SARS-CoV-2 Vaccine Responses","volume":"27","author":"Juliet Meir","year":"2021","journal-title":"Transplantation and Cellular Therapy","ISSN":"https:\/\/id.crossref.org\/issn\/2666-6367","issn-type":"print"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"104134","DOI":"10.1016\/j.critrevonc.2023.104134","article-title":"Infections in haematology patients treated with CAR-T therapies: A systematic review and meta-analysis","volume":"192","author":"Gemma K. 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