Invasive Fungal Disease After Chimeric Antigen Receptor-T Immunotherapy in Adult and Pediatric Patients

Pathogens, Journal Year: 2025, Volume and Issue: 14(2), P. 170 - 170

Published: Feb. 8, 2025

Invasive fungal diseases (IFDs) have been documented among the causes of post-chimeric antigen receptor-T (CAR-T) cell immunotherapy complications, with incidence IFDs in CAR-T therapy recipients being measured between 0% and 10%, globally. are notorious for their potentially life-threatening nature challenging diagnosis treatment. In this review, we searched recent literature aiming to examine risk factors epidemiology post-CAR-T infusion. Moreover, role antifungal prophylaxis is investigated. especially vulnerable due several that contribute patient’s immunosuppression. Those include underlying hematological malignancies, lymphodepleting chemotherapy administered before treatment, existing leukopenia hypogammaglobinemia, use high-dose corticosteroids interleukin-6 blockers as countermeasures immune effector cell-associated neurotoxicity syndrome cytokine release syndrome, respectively. mostly occur within first 60 days following infusion T cells, but cases even a year after described. Aspergillus spp., Candida Pneumocystis jirovecii main cause these infections therapy. More real-world data regarding population essential.

Language: Английский

Cancer-related cognitive impairment in patients with hematologic malignancies after CAR T cell therapy: a systematic review and meta-analysis of prevalence

Supportive Care in Cancer, Journal Year: 2025, Volume and Issue: 33(4)

Published: March 22, 2025

Abstract Purpose Cancer-related cognitive impairment is one of the symptoms neurotoxicity among patients receiving chimeric antigen receptor (CAR) T cell therapy. Evidence overall estimated prevalence cancer-related following CAR T-cell therapy with hematologic malignancies at short-term and long-term follow-ups lacking. This review aimed to summarize functioning status estimate follow-up within 1 month, 12 months, > months after Methods PubMed, Cochrane Library, EMBASE, CINAHL Plus, Web Science, PsycINFO via ProQuest from inception through August 2024. Studies that reported on valid measures were included. Data pooled using a random-effects model. Results In total, 16 studies involving 1407 The rates assessed neuropsychological tests timepoints (< 1–12 months) 24% [95% prediction interval (PI) 16–33%], 33% (95%, PI 9–64%), 35% 23–48%), respectively. estimates other ranging 4 38% across different timepoints. leave-one-out meta-analyses quantified impact these potential outliers estimation prevalence. Conclusions findings stress importance developing targeted interventions prevent or manage in cancer during both periods. also highlights need for further research this area improve our understanding disease mechanisms implement preventive strategies managing impairment.

Language: Английский

Genetic Susceptibility in Endothelial Injury Syndromes after Hematopoietic Cell Transplantation and Other Cellular Therapies: Climbing a Steep Hill

Current Issues in Molecular Biology, Journal Year: 2024, Volume and Issue: 46(5), P. 4787 - 4802

Published: May 15, 2024

Hematopoietic stem cell transplantation (HSCT) remains a cornerstone in the management of patients with hematological malignancies. Endothelial injury syndromes, such as HSCT-associated thrombotic microangiopathy (HSCT-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (SOS/VOD), and capillary leak (CLS), constitute complications after HSCT. Moreover, endothelial damage is prevalent immunotherapy chimeric antigen receptor-T (CAR-T) can be manifested cytokine release (CRS) or immune effector cell-associated neurotoxicity (ICANS). Our literature review aims to investigate genetic susceptibility syndromes HSCT CAR-T therapy. Variations complement pathway- function-related genes have been associated development HSCT-TMA. In these genes, CFHR5, CFHR1, CFHR3, CFI, ADAMTS13, CFB, C3, C4, C5, MASP1 are included. Thus, variations might predisposition activation, which also exaggerated by other factors (such acute graft-versus-host disease, infections, calcineurin inhibitors). Few studies examined SOS/VOD syndrome, implicated include CFH, methylenetetrahydrofolate reductase, heparinase. Finally, specific mutations onset CRS (PFKFB4, CX3CR1) ICANS (PPM1D, DNMT3A, TE2, ASXL1). More research essential this field achieve better outcomes for our patients.

Language: Английский